Neurointervention.  2014 Feb;9(1):50-52. 10.5469/neuroint.2014.9.1.50.

Conjoined Stent Technique for Radiation Induced Long Segment Carotid Stenosis and Pseudoaneurysm

• Vajpayee A
• Goyal G
• Kant R

• KMID: 1910775
• DOI: http://doi.org/10.5469/neuroint.2014.9.1.50

Abstract

Radiation induced carotid stenosis (RICS) is known but challenging complication of head and neck irradiation. Endovascular revascularization is preferred treatment modality than surgical revascularization. Sometimes endovascular treatment may be difficult in view of long segment of stenosis and associated pseudoaneurysm. We report a unique technique of carotid stenting named as "conjoined stent technique" in a challenging case of RICS with long segment of stenosis and pseudoaneurysm. In this technique we overlapped distal end of one stent with proximal end of second stent to occlude pseudoaneurysm. "Conjoined stent technique" may be viable option in case of long segment of RICS with associated pseudoaneurysm and alternative to flow diverters in extracranial carotid pseudoaneurysm.

Keyword

Radiation injuries; Pseudoaneurysm, carotid; Conjoined stent; Carotid stenosis/therapy

MeSH Terms

Aneurysm, False*
Carotid Artery Injuries
Carotid Stenosis*
Constriction, Pathologic
Head
Neck
Radiation Injuries
Stents*

Figure

• 

  Fig. 1 A. Long segment stenosis involving right common and internal carotid arteries (short arrows) with associated pseudoaneurysm (long arrow). B. Overlapping of distal end of the first stent with proximal end of second stent across the neck of pseudoaneurysm named as "Conjoined stent" (thick arrow). C. Digital subtraction angiogram after stenting and angioplasty shows revascularization of long segment of stenosis and good flow across the stent with complete disappearance of pseudoaneurysm.

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