Penetrating injuries to the internal carotid artery in zone III of the neck can be a significant challenge to the operating surgeon. Direct surgical exposure and repair of the internal carotid artery at the skull base can be extremely difficult, and surgical options for treatment of a pseudoaneurysm at this location are limited. We present a case of an 18-year-old man who sustained a single gunshot wound to the distal cervical internal carotid artery that led to a pseudoaneurysm managed with endovascular exclusion. Recent literature on the surgical and endovascular management of distal carotid injuries is reviewed.
There are multiple reports of externally deformed or crimped intravascular stents. Percutaneous salvage has been described in multiple anatomic locations including the carotid artery, coronary artery bypass grafts, and hemodialysis conduits. We report successful percutaneous salvage of severely crushed aortoiliac stents in a patient status post low anterior resection, chemotherapy, and radiation therapy for rectal carcinoma. A review of the literature describing approaches to externally deformed stents in other anatomic regions, the limited experience with crushed iliac stents, and our technique is presented.
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