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Endovascular treatment of the carotid stump syndrome
Giovanni Nano1, Ilias Dalainas, Renato Casana
1Istituto Policlinico San Donato, School of Vascular Surgery, University of Milan, Via Triulziana 36, San Donato, Milan 20097, Italy.
Insights
Carotid stump syndrome, a complication of internal carotid artery occlusion, can cause stroke symptoms. Endovascular stent-graft treatment offers a novel, minimally invasive option for this condition.
Area of Science:
- Vascular Surgery
- Neurology
- Interventional Cardiology
Background:
- Internal carotid artery occlusion can lead to carotid stump syndrome, a source of microemboli.
- This syndrome causes neurological symptoms despite internal carotid artery occlusion.
Observation:
- The carotid stump is a potential source of microemboli traveling via the external carotid and ophthalmic arteries.
- Symptoms manifest in the middle cerebral artery territory.
Findings:
- Surgical exclusion and endarterectomy are considered gold standard treatments.
- This report details the second case of successful endovascular treatment using a stent-graft for carotid stump syndrome.
Implications:
- Endovascular stent-grafting presents a minimally invasive alternative to surgery for carotid stump syndrome.
- This approach may offer a new treatment avenue for patients with this specific complication.
Abstract:
In patients with an occluded internal carotid artery, the carotid stump syndrome is a potential source of microemboli that pass through the ipsilateral external carotid artery and the ophthalmic artery to the territory of the middle cerebral artery. Thus, the syndrome is associated with carotid territory symptoms although the internal carotid artery is occluded. Surgical exclusion of the internal carotid artery associated with endarterectomy of the external carotid artery has been described as the gold standard of treatment by many authors. This report is the second case, to our knowledge, of endovascular treatment of the carotid stump syndrome with the use of a stent-graft.