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Neurology
Utilisation of a balloon-mounted coronary stent in the treatment of a patient with petrous carotid artery dissection
  1. Peter Atiiga1,
  2. Raghuram Lakshminarayan2 and
  3. Hamed Nejadhamzeeigilani1
  1. 1 Diagnostic and Interventional Neuroradiology, Hull University Teaching Hospitals NHS Trust, Hull, UK
  2. 2 Division of Vascular Radiology, Hull University Teaching Hospitals NHS Trust, Hull, UK
  1. Correspondence to Dr Hamed Nejadhamzeeigilani; hamednhg{at}gmail.com

Abstract

A man in his 50s presented with acute left-sided weakness, facial drooping and slurred speech, suggestive of a major stroke. Imaging revealed a complete blockage in the right internal carotid artery (ICA) due to dissection. Perfusion studies showed a significant area at risk of infarction. Attempted navigation of standard carotid stents failed due to the tortuosity of the ICA. A balloon-mounted coronary stent was successfully deployed in the petrous ICA segment, restoring blood flow. A follow-up MRI confirmed stent patency, and the patient achieved complete recovery with return to baseline function. Symptomatic carotid artery dissections can be treated with stenting to prevent strokes, however, tortuous ICAs in distal dissections pose a technical challenge. Balloon-mounted coronary stents, though not approved for this use, can offer a feasible solution. This case highlights the need for further research and development of devices for managing dissections in distal locations in tortuous ICAs.

  • Stroke
  • Neuroimaging
  • Interventional radiology

https://doi.org/10.1136/bcr-2023-258854

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    Footnotes

    • X @Unpronouncable1

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: PA, RL and HN. The following authors gave final approval of the manuscript: PA, RL and HN.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.