title: Emergent endovascular treatment of a spontaneous internal carotid artery dissection with pseudoaneurysm.
abstract: 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.
authors.affiliation: Department of Cardiovascular and Endovascular Surgery, Arizona Heart Institute and Hospital, Phoenix, Arizona 85006, USA. vramaiah@azheart.com
authors.forename: Albert
authors.initials: A
authors.lastname: Tseng
authors.forename: Venkatesh
authors.initials: V
authors.lastname: Ramaiah
authors.forename: Julio A
authors.initials: JA
authors.lastname: Rodriguez-Lopez
authors.forename: Paul E
authors.initials: PE
authors.lastname: Perkowshi
authors.forename: Peter B
authors.initials: PB
authors.lastname: Del Santo
authors.forename: Ramesh G
authors.initials: RG
authors.lastname: Gowda
authors.forename: Edward B
authors.initials: EB
authors.lastname: Diethrich
mesh_terms: 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