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Autologous vein-covered stent repair of a cervical internal carotid artery pseudoaneurysm: technical case report.

OBJECTIVE AND IMPORTANCE
Stenting of a cervical internal carotid pseudoaneurysm is presented using a stent covered with saphenous vein. This procedure resulted in immediate exclusion of the aneurysm and maintained patency of the carotid artery.


CLINICAL PRESENTATION
A gunshot to the neck resulted in airway obstruction and respiratory arrest with neurological injury in a male patient. Angiographic investigation revealed an enlarging cervical internal carotid pseudoaneurysm, possibly the source of a cerebral embolism. Anticoagulation had to be stopped because of bleeding complications. A decision was made to conduct definitive percutaneous treatment of the pseudoaneurysm.


TECHNIQUE
A Palmaz stent (JJIS, Warren, NJ) was covered with saphenous vein harvested from the patient's leg. Using standard technique and a simple innovation for stent construct introduction into the sheath, the vein-covered stent was placed across the opening of the aneurysm and dilated into position with a balloon.


CONCLUSION
Immediate exclusion of a cervical internal carotid pseudoaneurysm was performed using an autologous vein-covered stent. One-month follow-up confirmed continued exclusion of the pseudoaneurysm and carotid patency without stenosis.