title: Endovascular management of carotid artery stenosis secondary to sclerosing mediastinitis.
abstract: Sclerosing mediastinitis is a rare, progressive condition characterized by extensive fibrotic reaction. We report the first known case of symptomatic, extrinsic compression of the carotid artery by fibrotic extension of sclerosing mediastinitis. A 54-year-old woman began experiencing neurologic symptoms from extension of a known mediastinal mass resulting in 70% to 79% stenosis of the right internal carotid artery. The stenosis was treated with endovascular stenting. Completion angiogram revealed a good result with <10% residual stenosis. At 18-month follow-up, the patient was symptom free without evidence of re-stenosis. Endovascular therapy provides a novel and durable solution in the midterm to this very rare problem.
authors.affiliation: Department of Cardiovascular Surgery, Methodist DeBakey Heart and Vascular Center, The Methodist Hospital, Houston, TX 77030, USA.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Smolock
authors.forename: Shanda
authors.initials: S
authors.lastname: Blackmon
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Garami
authors.forename: Heitham T
authors.initials: HT
authors.lastname: Hassoun
mesh_terms: D000792:Angiography; D000800:Angioplasty, Balloon; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D057505:Embolic Protection Devices; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D005355:Fibrosis; D006801:Humans; D008480:Mediastinitis / Q000150:complications* / Q000473:pathology; D008875:Middle Aged; D015607:Stents; D018615:Ultrasonography, Doppler, Color; D018616:Ultrasonography, Doppler, Duplex