Case Report Iatrogenic Dissection of the Internal Carotid Artery: A Rare Case with Serious Consequences
by Luís Gustavo Biondi Soares1, José Alencar de Sousa Segundo2, Filipe de Almeida Agra Omena*3, Willian Pegoraro Kus4, Felipe Salvagni Pereira5, Nathaly Araújo Nogueira Abella3, Érika Patrícia Lima da Silva3, Rodolfo Igor Nunes Araujo3, Leandro Asis Barbosa1, Leonardo Bilich Abaurre1
1Hospital Estadual Central, Brazil
2Departamento de Neurocirurgia, Hospital Beneficência Portuguesa, Brazil
3Centro Universitário UNIFACISA, Brazil
4Departamento de Neurocirurgia, Hospital São Francisco, Brazil
5Faculdade Evangélica Mackenzie, Brazil
*Corresponding author: Filipe de Almeida Agra Omena, Centro Universitário UNIFACISA, Rua Terezinha de Farias, 167ª, Catolé, 58410-523 – Campina Grande, Brazil.
Received Date: 05 February, 2025
Accepted Date: 13 February, 2025
Published Date: 17 February, 2025
Citation: Soares LBG, Segundo JAS, Omena FAA, Kus WP, Pereira FS, et al. (2024) Iatrogenic Dissection of the Internal Carotid Artery: A Rare Case with Serious Consequences. J Neurol Exp Neural Sci 7: 155. https://doi.org/10.29011/2577-1442.100055
Abstract
Iatrogenic dissection of the internal carotid artery (ICA) is a serious complication associated with invasive procedures such as angiography and cervical surgery [1]. It occurs when there is an injury to the wall of the ICA, causing separation of the arterial layers and interruption of blood flow, and can lead to serious neurological complications, such as stroke¹. The dissection is not always visible on immediate angiography and can occur without evident signs [2]. Treatment may include antithrombotics or endovascular intervention [3].
We report the case of a 58-year-old female patient with systemic arterial hypertension and a history of subarachnoid haemorrhage, who was admitted for cerebral arteriography. During the procedure, a dissection was identified in the cervical segment of the right CIA, which had been absent in previous examinations. Urgent mechanical thrombectomy was chosen. After catheterization distal to occlusion, aspiration resulted in complete recanalization of the artery. Angioplasty was performed with a 4.5 x 50 mm LEO stent, restoring blood flow. The patient progressed well, with no immediate neurological changes, and was transferred to the ICU for continuous monitoring.
This case highlights the importance of rapid recognition and treatment of iatrogenic ICA dissection to prevent serious sequelae. Careful clinical practice and the adoption of thorough techniques are essential to improve the safety of endovascular procedures and ensure better outcomes.
Keywords: Carotid Dissection; Iatrogenic Dissection; Neurosurgery; Endovascular
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