Horner syndrome related to ipsilateral carotid wall hematoma after stent placement for the treatment of carotid stenoses.
OBJECTIVE
We prospectively studied the incidence and natural history of Horner syndrome following stent-supported percutaneous angioplasty of the carotid artery (SPAC). We assessed the hypothesis that postinterventional Horner syndrome is related to ipsilateral carotid wall hematoma.


METHODS
We performed duplex sonography of the carotid arteries and clinical examination in 28 consecutive patients before and 4 hours +/- 2, 24 hours +/- 2, and 7 days +/- 1 after SPAC.


RESULTS
Within 24 hours +/- 2 after SPAC, 11 of the 28 patients developed ipsilateral Horner syndrome. Ten of these 11 patients had a postinterventional sonographic appearance of a carotid wall hematoma, whereas only two of the 17 patients without Horner syndrome had this finding (P <.001). In all patients, both Horner syndrome and carotid wall hematoma had resolved 7 days +/- 1 after SPAC.


CONCLUSIONS
Horner syndrome appears to be a common yet transient event after SPAC. Although postinterventional Horner syndrome is significantly related to ipsilateral carotid wall hematoma, causality of the procedure-related formation of a carotid wall hematoma and oculosympathetic disturbance remains unproven.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon / Q000009:adverse effects*; D020212:Carotid Artery Injuries / Q000000981:diagnostic imaging / Q000209:etiology*; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging*; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D007839:Functional Laterality / Q000502:physiology; D006406:Hematoma / Q000000981:diagnostic imaging / Q000209:etiology*; D006732:Horner Syndrome / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009131:Muscle, Smooth, Vascular / Q000000981:diagnostic imaging / Q000293:injuries*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D015607:Stents / Q000009:adverse effects*; D018616:Ultrasonography, Doppler, Duplex