Fracture of a carotid stent: an unexpected complication

We present the first reported case of a carotid artery stent fracture where a Nitinol stent was used for the management of carotid artery stenosis. An 83-year-old man underwent right carotid artery stenting in July 2005. On follow-up ultrasound, stenosis of the right internal carotid artery was noted. In January 2006, he underwent left carotid artery stenting and at this procedure, precontrast assessment of the right neck revealed a complete fracture through the waist of the stent in the right internal carotid artery. This fractured segment correlated with the area of stenosis reported at the previous ultrasound. In July 2006, this gentleman underwent successful removal of the carotid stent with uneventful carotid endarterectomy and synthetic patch repair. Carotid artery stenting is a newer and alternative modality to carotid endarterectomy for the treatment of carotid artery stenting. More data are emerging to support its safety and efficacy. An unexpected complication can happen with any procedure and complications help define the follow-up management of subsequent patients undergoing this procedure.