Endovascular Carotid Stenting after Trauma

Blunt Cerebrovascular Injuries

“…[41][42][43][44][45][46][47] Not surprisingly, these case reports represent a diverse range of pathologies, symptoms, mechanisms of injury, and time to diagnosis. Although the majority appears to have patency of the stented carotid artery documented in followup radiographic evaluations, several cases of carotid artery occlusion following stent placement have been reported.…”

“…Although the majority appears to have patency of the stented carotid artery documented in followup radiographic evaluations, several cases of carotid artery occlusion following stent placement have been reported. 42,44 Our most recent evaluation indicates a prohibitive stroke and carotid occlusion rate associated with carotid stents placed in acutely injured vessels 11 ; additionally, long-term follow-up in patients with traumatic pseudoaneurysms who were treated with anticoagulant therapy alone has not been evaluated. Further understanding and evaluation of the role of appropriate concurrent antithrombotic therapy, as well as evolving stent technology including smaller delivery systems and covered stents, may improve the outcome for postinjury intraluminal carotid stents.…”

Endovascular implantation of covered stents in the extracranial carotid and vertebral arteries: Case series and review of the literature

“…[284583] Duane et al .,[8] reported an ICA dissection during covered stent placement for the treatment of a traumatic pseudoaneurysm. The patient was maintained on anticoagulation therapy, because endovascular treatment was delayed in order to allow healing of the operative site; however, at follow-up the stent was thrombosed.…”

Endovascular Treatment of Carotid and Vertebral Pseudoaneurysms with Covered Stents

“…8 In another study, a covered stent placed for delayed pseudoaneurysm after carotid endarterectomy (CEA) was found occluded at 6-month follow-up, despite the patient being on Coumadin. 14 Duane et al 15 describe the 2-year patency of a covered stent placed in the right ICA for traumatic pseudoaneurysm on daily ASA alone, whereas a covered stent in another patient of theirs was occluded at 6 weeks on ASA therapy. Kubaska et al 16 describe a 2-year patency of a covered stent placed in the left ICA for traumatic pseudoaneurysm after being treated with ASA and clopidogrel for just 30 days.OnecasereportdescribesaWallgraft(BostonScientific,Natick, Mass) covered stent placed in the carotid bulb for delayed pseudoaneurysm following CEA to be occluded at 12 months despite 6 weeks of clopidogrel followed by continued ASA.…”