Open surgical repair for in-stent restenosis of internal carotid artery covered stent-graft

Abstract

Extracranial carotid artery aneurysms (ECAA) are rare vascular anomalies defined as any aneurysmal dilatation of the common, external, or internal carotid artery leading up to the skull base. Operative management is indicated due to the high incidence of morbidity and mortality if left untreated. Endovascular techniques include aneurysm stent-graft exclusions, coil embolization, and transcarotid artery revascularization (TCAR). In-stent restenosis is a rare complication without established guidelines for re-intervention. We successfully treated a patient with in-stent restenosis of a covered stent graft placed to exclude an ECAA utilizing a common carotid artery to internal carotid artery bypass.

Keywords

• Carotid artery aneurysm
• In-stent restenosis
• TCAR
• Carotid bypass