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CASE REPORT
Emergency placement of stent-graft for symptomatic acute carotid artery occlusion after endarterectomy
  1. Jun Kyeung Ko1,
  2. Chang Hwa Choi1,
  3. Sang Weon Lee2,
  4. Tae Hong Lee3
  1. 1Department of Neurosurgery, Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
  2. 2Department of Neurosurgery, Medical Research Institute, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
  3. 3Department of Diagnostic Radiology, Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
  1. Correspondence to Dr Tae Hong Lee, Department of Diagnostic Radiology, Pusan National University Hospital, 179, Gudeok-ro, Seo-Gu, Busan 602-739, Republic of Korea; drcello@lycos.co.kr

Summary

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.

  • Stenosis
  • Stent
  • Stroke
  • Atherosclerosis
  • Dissection

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