Authors: Zhou, Wei; Bush, Ruth L.; Lin, Peter H.; Hodge, Megan D.; Felkai, Deborah D.; McCollum, Charles H.; Noon, George; Lumsden, Alan B.

Source: Journal for Vascular Ultrasound, Volume 29, Number 1, March 2005 , pp. 28-32(5)

Publisher: Society for Vascular Ultrasound

Abstract:

Purpose.—Carotid artery pseudoaneurysm development after endarterectomy, albeit rare, has been attributed to patch deterioration. We present an unusual case of pseudoaneurysm development 1 year after stent placement for recurrent carotid artery stenosis.

Case Report.—A 64-year-old man had transient hemiparesis develop 1 week after carotid artery endarterectomy (CEA) with patch angioplasty for monocular transient ischemic attack. Carotid angiography reviewed an intimal flap at the distal endarterectomy site, which was successfully treated with carotid stent placement. During a duplex scan 1 year later, he was found to have a symptomatic 2.5-cm pseudoaneurysm at the level of stented carotid bifurcation. This was successfully treated with a combined open and endovascular approach, which consisted of stentgraft placement by means of an open carotid exposure. Completion angiogram showed successful stent-graft exclusion of the pseudoaneurysm. A follow-up duplex scan 6 months later demonstrated diminution of pseudoaneurysm size without endoleak.

Conclusion.—This report highlights the importance of duplex ultrasound surveillance in patients with CEA or carotid stenting, because it can accurately detect recurrent stenosis or carotid pseudoaneurysm. Moreover, a combined open and endovascular therapy using stent graft successfully treated the carotid pseudoaneurysm in our patient.

Document Type: Case report

Publication date: 2005-03-01

More about this publication?

• The Journal for Vascular Ultrasound (JVU) is the official journal of the Society for Vascular Ultrasound. It consists of original scientific and educational articles, case studies, book reviews, technical reviews, ultrasound principle reviews, viewpoints, letters to the editor, and CME tests. Regular reading of JVU, published quarterly, will keep you current in your field and provide essential information that can be applied in your practice.
  
  Previously known as the Journal of Vascular Technology - View Volumes 16-26 here
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• In this Subject: Radiology & Imaging ,  Acoustics
• By this author: Zhou, Wei ;  Bush, Ruth L. ;  Lin, Peter H. ;  Hodge, Megan D. ;  Felkai, Deborah D. ;  McCollum, Charles H. ;  Noon, George ;  Lumsden, Alan B.

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