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* Date : 06-08-2009 - 07:50 PM (285 days ago), * Characters : 1856, Words : 267, Size : 1.81 Kb.

Use of Covered Stent Grafts in the Extracranial Carotid Artery: Report of three patients with follow-up between 8 and 42 months.

The initial results of these case reports suggest that the use of covered stent grafts in the carotid artery can be a safe and effective alternative to conventional surgery and other endovascular techniques. Currently, most carotid artery pathologic abnormalities resulting in pseudoaneurysm formation or stenosis are repaired by surgical intervention (1). Parent vessel occlusion may be impractical if the patient is unable to tolerate occlusion of that artery (2). As seen in the above described intimal hyperplasia case report, recurrence is a possibility after angioplasty and uncovered wall stent placement; however, intimal hyperplasia did not recur in the portion of the carotid artery treated with a covered stent graft (3). More cases with long-term follow-up are needed to determine the potential role for this technique as a routine treatment for the repair of carotid artery pseudoaneurysms and recurrent intimal hyperplasia.

Summary: Currently, most carotid artery pathologic abnormalities resulting in pseudoaneurysm formation or stenosis are repaired by surgical intervention. Because surgical intervention requires proximal and distal control of the artery, pseudoaneurysms near the skull base may be very difficult to repair and pose greater risk to the patient. As a result, endovascular techniques have evolved in an effort to reduce morbidity associated with surgical techniques. Parent vessel occlusion and coil placement are the most frequently used endovascular techniques for carotid artery repair of pseudoaneurysms. Intimal hyperplasia is generally treated with balloon angioplasty, often in conjunction with uncovered stent placement. Parent vessel occlusion may be impractical if the patient is unable to tolerate occlusion of that artery. We report our experience in treating three patients with carotid artery stent grafts.

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