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Covered Stent Deployment and Follow-Up of a Case of Internal Carotid Artery Pseudoaneurysm

Introduction Endovascular stents are being used with increasing frequency in interventional radiology of the carotid arteries. The first attempt to place a stent to treat an internal carotid artery pseudoaneurysm was made by Marks et al. [1] in 1994 who published a report of two cases. In 1995 Nicholson et al. [2] reported the use of a covered stent to exclude an internal carotid pseudoaneurysm. Since these first reports, several materials have been employed in this less invasive alternative to open surgery. Also, experimental studies have been performed in animals evaluating the occurrence of luminal narrowing after covered stent placement: stenoses are due to the ingrowth of intimal hyperplasia on the internal layer of the stent, mostly at its edges. Initially Dacron, PET and, in rare instances, silicone were used in human arteries, but now, autologous vein and polytetrafluoroethylene (PTFE) are preferred due to their lower rate of subsequent stenosis [2–10]. In our case, we decided to treat the patient by endovascular means using a PTFE-covered nitinol stent, since surgery would have been technically very complex due to the high position of the pseudoaneurysm at the skull base.