Emergent Rescue Extracranial-Intracranial Bypass for Acute Carotid Stent Thrombosis Report

Abstract

Background: Acute stent thrombosis is a rare adverse event following endovascular treatment of carotid artery. Experience on the topic is scarce, making the therapeutic approach a clinical challenge. In cases of intraprocedural acute carotid stent thrombosis, thromboaspiration, thrombectomy, and thrombolysis have been used as successful modalities for achieving recanalization.

Case description: We describe a case of carotid artery dissection treated endovascularly and complicated by intraprocedural stent thrombosis, which was ultimately managed by emergent extracranial-intracranial bypass with radial artery graft connecting the external carotid artery to the ipsilateral middle cerebral artery.

Conclusions: Neurosurgical management may represent a rescue option for otherwise unmanageable acute carotid stent thrombosis.

Keywords: Carotid artery thrombosis; Extracranial-intracranial arterial bypass; Internal carotid artery dissection; Stent.