Emergent endovascular treatment of a spontaneous internal carotid artery dissection with pseudoaneurysm.
OBJECTIVE
To report the use of a coronary stent-graft for the endovascular treatment of a spontaneous internal carotid artery (ICA) dissection complicated by a large pseudoaneurysm.


METHODS
A 68-year-old man presented to an outside hospital with complaints of headache, severe left-sided neck pain, fever, chills, and vomiting. Contrast-enhanced computed tomography revealed a large (3.5x3 cm) extracranial aneurysm of the left ICA. The patient was emergently transferred to our facility for endovascular treatment of the carotid aneurysm. Via a percutaneous access in the right common femoral artery, 2 Jostent coronary stent-grafts were deployed across the aneurysm with no evidence of a residual pseudoaneurysm. The patient was hemodynamically stable throughout the procedure. Duplex examination at 9 months revealed no evidence of a residual pseudoaneurysm, dissection, or endoleak.


CONCLUSIONS
Covered coronary stents may have a role in the treatment of spontaneous ICA dissection with pseudoaneurysm formation.
Tseng
Albert
A
Department of Cardiovascular and Endovascular Surgery, Arizona Heart Institute and Hospital, Phoenix, Arizona 85006, USA. vramaiah@azheart.com
Ramaiah
Venkatesh
V
Rodriguez-Lopez
Julio A
JA
Perkowshi
Paul E
PE
Del Santo
Peter B
PB
Gowda
Ramesh G
RG
Diethrich
Edward B
EB
D000368:Aged; D017130:Angioplasty; D020215:Carotid Artery, Internal, Dissection / Q000150:complications / Q000601:surgery*; D020216:Carotid-Cavernous Sinus Fistula / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male