Author + information
- Received December 21, 2016
- Accepted December 29, 2016
- Published online March 20, 2017.
- Fabrizio Tomai, MDa,∗ (, )
- Giovanni De Persio, MDa,
- Alessandro Petrolini, MDa,
- Luca Altamura, MDa,
- Nicola Corcione, MDb and
- Raoul Borioni, MDa
- aDepartment of Cardiovascular Sciences, European Hospital, Rome, Italy
- bCastelvolturno, Caserta, Italy
- ↵∗Address for correspondence:
Dr. Fabrizio Tomai, Department of Cardiovascular Sciences, Division of Cardiology, European Hospital, Via Portuense 700, Rome 00149, Italy.
A 73-year-old man with multidistrict artery disease was referred to our hospital for carotid artery stenting of an 85% stenosis of the right internal carotid artery (Figure 1A). Protected carotid artery stenting of the right internal carotid artery was performed with a 7 × 40 mm Carotid Wallstent (Boston Scientific, Natick, Massachusetts), post-dilated with a 5 × 20 mm balloon (Figure 1B). Seven days later, the patient exhibited a pulsatile neck mass and underwent computed tomography showing 2 large pseudoaneurysms at both proximal and distal stent edges (Figure 1C), requiring urgent endovascular treatment. After diagnostic angiography (Figure 1D), a 0.014-inch guidewire was positioned in the distal tract of the right internal carotid artery to facilitate distal positioning of a 0.035-inch wire. Then, 2 overlapping, covered Be-graft stents (Bentley InnoMed GmbH, Hechingen, Germany) were implanted with complete exclusion of the pseudoaneurysms (Figure 1E), without any complication. Extracranial carotid artery pseudoaneurysm is an infrequent lesion most commonly traumatic, spontaneous, or iatrogenic in origin (1). Iatrogenic lesions include complications of carotid endarterectomy or central venous catheterization. The incidence of pseudoaneurysm formation secondary to carotid stenting is extremely rare. To the best of our knowledge, this is the first case of pseudoaneurysm formed at both proximal and distal carotid stent edges a few days after the procedure, successfully treated with implantation of covered stents.
All authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received December 21, 2016.
- Accepted December 29, 2016.
- 2017 American College of Cardiology Foundation