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In-stent stenosis in the patient with internal carotid aneurysm after treated by the Willis covered stent: Two case reports and literature review. | LitMetric

In-stent stenosis in the patient with internal carotid aneurysm after treated by the Willis covered stent: Two case reports and literature review.

Medicine (Baltimore)

Department of Neurosurgery, West China Hospital School of Basic Science and Forensic Medicine, Sichuan University, Chengdu, Sichuan, People's Republic of China.

Published: February 2017

Unlabelled: In-stent stenosis after treated by Willis covered stent-case reports.

Background: Advancements in minimally invasive technology have allowed endovascular reconstruction of internal carotid aneurysm. However, in-stent stenosis is an important and well-characterized complication of stenting after the treatment of internal carotid aneurysm.

Case Description: We would present 2 patients who were diagnosed with in-stent stenosis after the treatment of Willis covered stent. Case 1: A 57-year-old female with 2-week history of headache and vomiting before admission, whose digital subtraction angiography (DSA) demonstrated left internal carotid C6 aneurysm and showed about 20% stenosis 3 months later since operation in the position where Willis covered stent was deployed. Case 2: A 23-year-old male with skull base fracture, subarachnoid hemorrhage, right femoral fracture for 14 days and epistaxis for 9 hours caused by a car accident, whose DSA demonstrated left internal carotid paracliniod pseudoaneurysm. One year later, the patient went to our center again because he had headache and dizziness for 6 months after the interventional operation. His DSA demonstrated about 80% stenosis in the position where Willis covered stent was deployed. The clinical and radiologic characteristics and the experience in dealing with the stenosis are presented.

Conclusions: In-stent stenosis after treated with Willis covered is uncommon, but not rare. Operators should pay more attention to the in-stent stenosis during the period of follow-up observation and monitor P2Y12 Reaction Unit (PRU) in the antiplatelet period, especially for the Willis covered stent. What is more, the treatment for stenosis ought to be carefully considered.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5319513PMC
http://dx.doi.org/10.1097/MD.0000000000006101DOI Listing

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