Abstract
Purpose: To report a case of carotid artery dissection after carotid endarterectomy (CEA) successfully treated with carotid artery stenting (CAS).
Case presentation: A 64-year-old man with cerebral infarction and central retinal artery occlusion due to left proximal internal carotid artery stenosis was treated with CEA. Postoperative MRA and 3D-CTA demonstrated asymptomatic carotid artery dissection. The entry point of the dissection was located 1 cm distal to the distal edge of the endarterectomy, where puncture with a 24-G needle for measuring stump pressure measuring was performed. Carotid artery dissection became prominent on 3D-CTA after 3 months. CAS with Angioguard XP / PECISE stent was performed. Complete repair of the carotid artery dissection was achieved.
Conclusion: CAS offers a safe and effective treatment for post-endarterectomy carotid dissection. 3D-CTA is useful for 3-dimensional evaluation of carotid artery dissection. A distal protection filter device, which allows intraoperative angiography, is useful for accurate positioning of the stent.
