Abstract
Objective: Dissection of the carotid artery can lead to pronounced stenosis, occlusion, or pseudoaneurysm formation, with subsequent formation of hemodynamic and embolic infarcts, despite anticoagulant therapy. We report a case in which coil embolization assisted with carotid artery stenting was performed for spontaneous dissection of the common carotid artery (sdCCA) with pseudoaneurysm.
Case presentation: A 68-year-old man visited our hospital complaining of neck pain. CTA revealed irregularities of the carotid wall and stenosis of the common carotid artery, whereas MRA did not demonstrate any abnormalities. Therefore we performed conservative therapy for sdCCA. However, this resulted in the formation of a pseudoaneurysm. The pseudoaneurysm enlarged gradually during the following several weeks. We determined that coil embolization assisted with carotid artery stenting was indicated for sdCCA. Coil embolization was performed under local anesthesia, which successfully reduced the pain and swelling of the neck.
Conclusion: Minimally invasive coil embolization assisted by carotid artery stenting is a useful alternative for cases presenting with sdCCA that exhibit resistance to conservative therapy.
