A Patient Who Underwent Stenting for Dissection That Occurred during Carotid Endarterectomy

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Purpose: We report a patient who underwent stenting for dissection related to internal-shunt insertion during carotid endarterectomy (CEA).

Case Presentation: A 77-year-old female with a history of stenosis of the left carotid artery. During admission due to infectious enteritis, right hemiplegia occurred, and arteriogenic embolism was observed. After an improvement in the general condition was achieved, CEA was performed. Intimal thickening involving the periphery to the most stenotic site was noted. When inserting a shunt into the internal carotid artery, there was a resistance, and there was no blood flow regurgitation, suggesting iatrogenic dissection. After plaque removal and vascular suture, the patient was transferred to the angiography room while maintaining general anesthesia, and a stent was inserted to the site of dissection. Anterograde blood flow was achieved, and the postoperative course was favorable.

Conclusion: Stenting for carotid artery dissection related to shunt insertion during CEA may be effective.