PMC6330184_01
Three-dimensional facial bone computed tomography imaging showing Le Fort I maxillary fracture, medially displaced and fractured right condyle, and dentoalveolar fracture involving the lower anterior segment.
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Facial bone computed tomography (CT) showed lower anterior dentoalveolar fracture with lingual displacement, bilateral Le Fort I fractures of the maxillae, and medially displaced and fractured right condylar neck [Figure 1].
Selective angiogram of the right internal carotid artery (ICA) showing focal dissecting aneurysm of the extracranial part of the right ICA (arrows).
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However, the angiogram did not show any major source of bleeding in relation to the internal maxillary artery, but identified a large DA of the extracranial part of the right ICA [Figure 2].
Intraoperative surgical exposure demonstrating dissecting aneurysm of the right internal carotid artery (arrow). Note the close anatomical relation of the lesion to the base of skull.
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However, due to the additional intracranial extension of the lesion this was difficult [Figure 3].
Post-right internal carotid artery stenting angiogram showing resolution of a dissecting aneurysm.
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Six days later, through the femoral approach, the patient underwent endovascular insertion of a 50 x 6 mm self-expandable covered arterial stent with no distal carotid embolic protection, which resulted in complete resolution of the vascular lesion with no complications [Figure 4].