Management of Ruptures Complicating Angioplasty and Stenting of Supraaortic Arteries: Report of Two Cases and a Review of the Literature
L. Paul Broadbenta,
Christopher J. Morana,
DeWitte T. Cross, IIIa and
Colin P. Derdeyna
a From the Mallinckrodt Institute of Radiology, Department of Neuroradiology, St. Louis, MO
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FIG 1. A 72-year-old woman who had undergone a prior right carotid endarterectomy.
A, Right common carotid injection shows 75% stenosis of proximal right common carotid and 90% stenosis of the right internal carotid artery near the proximal endarterectomy site.
B, Frontal view of overlapping 10 x 20-mm stents in the right common carotid artery. The SMART stent is more distal as compared with the Wallstent.
C, Right common carotid arteriogram after stent placement shows contrast material extravasation medial to the stents.
D, Arch angiogram obtained 7 weeks later shows no signs of vessel injury.
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FIG 2. A 72-year-old woman with recurrent stenosis after angioplasty and stent placement of a high-grade stenosis in the proximal right subclavian artery.
A, Injection of the guide catheter in the innominate artery before angioplasty of the right vertebral artery origin. The lumen of the stenotic segment is nearly the same diameter as that of the guide catheter. Another stenosis is in the right subclavian artery distal to the vertebral artery.
B, Innominate injection shows extravasation of contrast material after the second angioplasty of the right subclavian artery.
C, Arch aortogram the following day demonstrates a pseudoaneurysm.
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AJNR - American Journal of Neuroradiology