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Case Reports
. 2023 Oct 12;15(10):e46933.
doi: 10.7759/cureus.46933. eCollection 2023 Oct.

A Rare Case of Isolated Spontaneous Common Carotid Artery Dissection Treated by Telescoping Stents

Yoon-Soo Lee  1
Affiliations
Case Reports

A Rare Case of Isolated Spontaneous Common Carotid Artery Dissection Treated by Telescoping Stents

Yoon-Soo Lee. Cureus. .

Abstract

An isolated spontaneous common carotid artery (CCA) dissection is an extremely rare cause of stroke, and standard treatment guidelines are not yet established. This case report presents a rare case of isolated spontaneous CCA dissection but with typical and obvious radiological findings, and it could be informative and educational to clinicians. Telescoping multiple carotid stents can be a feasible treatment option for this case with recurrent ischemia due to a long segment dissection.

Keywords: carotid stent; common carotid artery; dissection; isolated; spontaneous; telescoping.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Initial radiological findings
(A) Diffusion-weighted magnetic resonance imaging reveals multi-focal infarctions on the right hemisphere. (B, C) Neck magnetic resonance angiogram and its source image show a moderate stenosis (white arrowheads) from the right mid to distal common carotid artery. (D). The cross section of carotid ultrasonography shows a lumen (white arrow) in a semilunar shape and thrombus (black arrow) in the remaining semilunar portion.
Figure 2
Figure 2. Follow-up radiological findings
(A) Diffusion-weighted magnetic resonance imaging on the fourth day shows an increased number of multi-focal infarctions. (B) Neck magnetic resonance angiogram reveals a newly developed flow (white arrow) in the false lumen. Note the dynamic and unstable changes in the morphology of the mural hematoma when compared to the initial neck magnetic resonance angiogram.
Figure 3
Figure 3. Intra- and post-operative radiological findings
(A) Carotid angiogram showed an irregular intimal flap (white arrowheads) with the false lumen (white arrow) and the remaining mural hematoma. (B) Stenting (black arrowheads) is performed using two stents in a telescoping configuration with an overlapping at the mid portion. Note that the false lumen is completely collapsed and the true lumen is fully enlarged. (C) Coronal section of the head-neck computed tomography angiography a week later shows a patent flow within the carotid stents.
See this image and copyright information in PMC

References

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