Endovascular management of penetrating carotid trauma with a flow-diverting stent

Abstract

The use of flow-diverting stents in penetrating trauma is not widely documented in the literature. Here we present an index case of a 33-year-old male patient who developed a pseudoaneurysm in the distal right internal carotid artery secondary to multiple gunshot wounds. Operative management was necessitated by interval enlargement over two months. A flow-diverting stent (FDS) was used to exclude the pseudoaneurysm, and an additional self-expanding uncovered stent was deployed across the proximal portion of the FDS for support. Seven months post-procedure, there was full radiographic resolution of the lesion, and the patient remained fully asymptomatic and without neurologic deficits. Flow-diverting stents may be useful for the endovascular management of traumatic vessel injury, and further research is needed to determine the appropriate role of these devices relative to alternative treatment options.