Pseudoaneurysm after carotid stenting: A case report and review of literature [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. Ahead of Print: TKDA-34609 | DOI: 10.5543/tkda.2020.34609

Pseudoaneurysm after carotid stenting: A case report and review of literature

Ahmet Güner1, Selçuk Pala2, Sabahattin Gündüz3, Şeyhmus Külahçıoğlu2, Ezgi Gültekin Güner1
1Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Cardiology
2Department of Cardiology, Kartal Kosuyolu Heart Training&Research Hospital
3Department of Cardiology, VM Pendik Medical Park Hospital

Carotid artery stenting (CAS) is becoming more widely used as an alternative to carotid endarterectomy in the treatment of carotid artery stenosis. Most carotid artery studies concentrated mainly on the short-term cardiac and neurologic complications of CAS. Less emphasis has been made on long-term complications such as restenosis, stent fracture, and carotid pseudoaneurysms (PAs). Extracranial carotid artery PA is an infrequent lesion which can arise from varying causes including trauma (most common cause), spontaneous, infections, vasculitides (such as Behçet disease) or as an iatrogenic complication following procedures. The incidence of pseudoaneurysm formation secondary to carotid stenting is extremely rare. The main causes are infection, stent fracture, arterial wall injury by stent struts, hyperextension of the neck and degeneration of arterial wall. Symptoms can range from completely asymptomatic forms to neck swelling, nerve compressions, respiratory distress, hoarseness, and dysphagia and ischemic cerebrovascular events. Once the diagnosis is made, the treatment is recommended in order to avoid the rupture, distal embolization, and nervous compression; furthermore, several studies reported a stroke prevalence of 50% and a mortality of 60% to 70% when PAs are left untreated. Several surgical treatments have been described, including both primary closure and patch angioplasty or graft interposition. The endovascular approach with the insertion of a covered/ bare metal stent is an alternative option. Herein, we present a clinical case of PA after CAS. We also reviewed all the cases of carotid PAs after CAS described in the literature.

Keywords: Carotid artery, pseudoaneurysm, endovascular tretment, death

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Corresponding Author: Ahmet Güner, Türkiye
© Copyright 2020 Archives of the Turkish Society of Cardiology
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