Immediate surgery for acute internal carotid artery dissection and thrombosis during filter deployment prior to stenting: a case report.

Abstract:

:Carotid artery stenting (CAS) is a validated option in the treatment of selected extracranial carotid artery stenosis. Carotid artery dissection during CAS is a rare but potentially devastating complication. We report a case of acute dissection and thrombosis of the left internal carotid artery during filter tip wire engaging maneuvers, complicated by intraoperative complete blindness of the left eye. Immediate conversion to carotid endarterectomy was performed under general anesthesia with electroencephalographic monitoring. The patient was discharged home symptomless and remains asymptomatic eight months after the operation, with normal left internal carotid patency and fully recovered eyesight. In conclusion, the management of acute carotid occlusion during CAS requires emergent evaluation and definitive endovascular or open surgical repair to minimize neurologic morbidity. We advocate that all endovascular procedures are carried out in a well-established surgical environment.

journal_name

Vascular

journal_title

Vascular

authors

Tolva V,Bertoni GB,Bianchi PG,Keller GC,Casana R

doi

10.1177/1708538113478774

subject

Has Abstract

pub_date

2013-08-01 00:00:00

pages

247-50

issue

4

eissn

1708-5381

issn

1708-539X

pii

1708538113478774

journal_volume

21

pub_type

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