Endovascular treatment of common carotid artery dissection via the superficial temporal artery.

Abstract

PURPOSE:

To describe the endovascular treatment of an iatrogenic common carotid artery (CCA) dissection using the superficial temporal artery (STA) as the principal access.

TECHNIQUE:

An 83-year-old man with a post-carotid endarterectomy left CCA dissection was admitted for a transient ischemic attack involving the left cerebral hemisphere that occurred despite proper anticoagulation. After excluding redo surgery and transfemoral stenting (owing to a partially compromised aortobifemoral bypass graft), stenting of the left CCA dissection was planned using a right transbrachial approach, with the left STA as an additional access. However, intraoperative angiography showed an acute angle between the innominate artery and left CCA, so the STA was used as the primary access route owing to its straight course and 4-mm diameter. The 9-x40-mm self-expanding stent was inserted via a 5-F sheath in the STA and deployed directly at the CCA dissection. The procedure was successful, and all vessels involved were patent at 6-month follow-up.

CONCLUSION:

In selected cases, the superficial temporal artery may represent a valid alternative approach for the endovascular treatment of short CCA dissections.

• Authors: Nazzareno Stella, Giovanni Palombo, Federico Filippi, Cristiano Fantozzi, Maurizio Taurino
• Journal: Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists (J Endovasc Ther) Vol. 17 Issue 4 Pg. 569-73 (Aug 2010) ISSN: 1545-1550 [Electronic] United States
• PMID: 20681778 (Publication Type: Case Reports, Journal Article)

Topics

• Aged, 80 and over
• Aortic Dissection (diagnostic imaging, etiology, therapy)
• Angioplasty, Balloon (instrumentation, methods)
• Carotid Artery Diseases (diagnostic imaging, etiology, therapy)
• Carotid Artery, Common (diagnostic imaging)
• Endarterectomy, Carotid (adverse effects)
• Humans
• Iatrogenic Disease
• Male
• Stents
• Temporal Arteries
• Tomography, X-Ray Computed
• Treatment Outcome