title: Emergency placement of stent-graft for symptomatic acute carotid artery occlusion after endarterectomy.
abstract: A patient underwent a left-sided carotid endarterectomy (CEA) for an asymptomatic 80% carotid artery (CA) stenosis. There were no signs of intolerance during the carotid cross-clamping and an initially uneventful awakening was observed. However, in the third postoperative hour he experienced left amaurosis and dysarthria. An urgent MRI showed an occluded internal CA on the operated site without evidence of acute infarction. To recanalize the occluded internal CA and minimize leakage from the arteriotomy site, a self-expandable stent-graft was placed, covering the dissection and the distal atherosclerotic lesions. Complete recanalization of the left internal CA was achieved and the patient showed a dramatic improvement of his preoperative deficits. To our knowledge, this is the first case of stent-graft implantation for a symptomatic acute CA occlusion following CEA. Stent-graft placement should be considered as an alternative method of treatment for acute CA occlusion or dissection following CEA.
authors: Department of Neurosurgery, Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.
authors: Jun Kyeung
authors: JK
authors: Ko
authors: Department of Neurosurgery, Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.
authors: Chang Hwa
authors: CH
authors: Choi
authors: Department of Neurosurgery, Medical Research Institute, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea.
authors: Sang Weon
authors: SW
authors: Lee
authors: Department of Diagnostic Radiology, Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.
authors: Tae Hong
authors: TH
authors: Lee
mesh_terms: D000208:Acute Disease; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000601:surgery*; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D004638:Emergency Treatment / Q000379:methods*; D016894:Endarterectomy, Carotid / Q000009:adverse effects*; D006801:Humans; D008297:Male; D015607:Stents
keywords: Atherosclerosis; Dissection; Stenosis; Stent; Stroke