Endovascular Stent Repair of a Carotid Artery Pseudoaneurysm

JUNE 2005 I ENDOVASCULAR TODAY I 29 C arotid pseudoaneurysm formation complicates 0.3% of all carotid endarterectomies.1 Mechanisms include suture failure, degeneration of the arterial wall and/or path material, trauma, and/or infection. Intra-aneurysmal turbulent flow promotes clot formation and dislodgment, with subsequent intracerebral embolization. Without treatment, pseudoaneurysms pose a long-term risk of embolization or flow-related complications. Conventional repair is effective but can be technically challenging due to pseudoaneurysm location or size. Endovascular repair for injuries of the extracranial carotid artery system is not only less invasive but can potentially be the only feasible option. The high position of many of these lesions often makes traditional open repair technically difficult.1-4 The authors present a case of endovascular repair of an internal carotid artery pseudoaneurysm after internal carotid artery stenting for recurrent stenosis, using the Wallgraft endoprosthesis (Boston Scientific Corporation, Natick, MA).