Related Experiment Video
Updated: Jun 25, 2026
A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
Intracranial dissection during carotid endarterectomy treated by carotid stenting
N Attigah1, M Ganten, A Hyhlik-Dürr
1Department of Vascular Surgery and Endovascular Surgery, University of Heidelberg, Germany. nicolas.attigah@med.uni-heidelberg.de
Insights
Intracranial dissection of the internal carotid artery (ICA) after carotid endarterectomy (CEA) can be fatal. Stenting the ICA effectively restored blood flow and prevented further complications in a patient.
Area of Science:
- Vascular Surgery
- Interventional Neurology
- Cerebrovascular Disease
Background:
- Carotid endarterectomy (CEA) is a common procedure to prevent stroke.
- Intracranial dissection of the internal carotid artery (ICA) is a rare but severe complication following CEA.
- Prompt diagnosis and management are crucial to prevent catastrophic neurological deficits.
Observation:
- A 67-year-old male presented with symptomatic high-grade internal carotid artery stenosis.
- Intraoperative completion angiography after CEA revealed thrombotic occlusion of the ICA.
- A subsequent dissection of the petrous ICA was identified on completion angiography.
Findings:
- The occluded ICA was resected and replaced with a Dacron graft.
- A coronary artery stent was successfully deployed to address the petrous ICA dissection.
- Cerebral perfusion was restored without significant delay, confirmed by imaging.
Implications:
- Stenting the ICA is an effective method for immediate restoration of cerebral blood flow after dissection during CEA.
- Intraoperative completion angiography is vital for the early detection of dissections.
- This case highlights the utility of endovascular techniques in managing CEA complications.
Abstract:
Intracranial dissection of the internal carotid artery after carotid endarterectomy (CEA) is a serious complication with a potentially fatal outcome. We report on a 67 male with a symptomatic high grad stenosis of the internal carotid artery. Intraoperative completion angiography showed a thrombotic occlusion and the internal carotid artery (ICA) was resected with interposition of a Dacron graft. Completion angiography then revealed a dissection of the petreous ICA, which was corrected by insertion of a coronary artery stent.Stenting of the ICA is a useful tool to restore cerebral perfusion without time delay and completion imaging is extremely helpful for early detection of dissection during CEA.