Fracture of a Carotid Stent: A Word of Caution

摘要

Carotid artery stent (CAS) placement with embolic protection is increasingly being regarded as a treatment alternative for patients with internal carotid artery stenosis who are at high risk for carotid endarterectomy. However, long-term results of CAS placement and detailed information of the behavior of metal stents in the carotid artery are still sparse. As the use of this technique expands and the number of reported incidences of complications related to this procedure grows, we suggest that further studies systematically assess the incidence and clinical implications of stent fractures after CAS placement. Herein, we offer additional evidence of CAS fracture and the associated restenosis at the fracture site.In June 2006, we encountered a 70-year-old woman who was referred for CAS placement for a left common and internal carotid artery stenosis. Her symptoms included transient ischemic attacks and amaurosis twice, with the last event occurring 1 week before referral. Two months earlier, she had undergone successful CAS placement in the right internal carotid artery for an 80% de novo stenosis. Her risk factors included type II diabetes mellitus, hypercholesterolemia,and hypertension. In addition, she had undergone laryngectomy and neck irradiation for laryngeal carcinoma 20 years ago.