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Updated: Dec 24, 2025
Endovascular Perforation Model for Subarachnoid Hemorrhage Combined with Magnetic Resonance Imaging MRI
Published on: December 16, 2021
Endovascular Repair of a Common Carotid Artery Perforation during Pacemaker Insertion
Sergio Palermo1, Gianluca Faggioli1, Stefano Ancetti1
1Vascular Surgery, Department of Experimental, Diagnostic and Specialty Medicine, DIMES, University of Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy.
Background:
We report the percutaneous endovascular management of an iatrogenic perforation of the left common carotid artery (LCCA) during an attempted trans-subclavian pacemaker (PM) placement.
Methods:
An 87-year-old woman was urgently transferred after an attempted left subclavian vein PM implantation. Computed tomography angiography scan showed the accidental cannulation of LCCA in its most proximal segment. Owing to the significant surgical risks, the mortality rate, and the distal position of the vessel from the skin, we opted for an endovascular strategy with a balloon-expandable stent graft. The Advanta 8 × 38 mm V12 was inserted via a 7 French Flexor Introducer sheath through the right common femoral artery.
Results:
The patient was discharged on postoperative day 2 without complications. A 6-month follow-up computed tomography angiography demonstrated stent graft and LCCA patency and the patient was in a good stable condition.
Conclusions:
This case highlights the effectiveness of a minimal invasive endovascular approach to treat this uncommon but potentially lethal injury.
