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Carotid Pseudoaneurysms Secondary to Dissection: Endovascular Management with Bare Stent-Graft

Introduction About 10–25% of strokes in young adults are due to dissections of carotid arteries [1]. If blood penetrates between the intima and media, it may develop lumina narrowing and vessel occlusion. If the dissection takes place between the media and adventitia, an aneurysmal defect may appear. Arterial dissections occur spontaneously or are associated with traumatic injuries [2]. Aneurysmal forms represent approximately one third of the cases of dissection. The clinical sequelae are variable, ranging from cervical and facial pain, stroke, retinal ischemia to lower cranial nerve paralysis [3]. Traditionally, the diagnosis has been made by angiography, but now, magnetic resonance (MR) and MR angiography are the diagnostic techniques of choice because they allow to observe the hematoma in the wall of the vessel. The management of pseudoaneurysms is usually conservative using antithrombotic therapy because their evolution is usually benign. If, in spite of this, clinical events persist, an endovascular or surgical treatment is necessary. We report a case of two internal-carotid-artery (ICA)-dissecting pseudoaneurysms successfully treated endovascularly with a carotid wall stent without adjunctive coil embolization.