Prevention of Stroke with Closed-Cell Stent-in-Stent for Carotid Artery Stenosis Due to Stent Fracture.

Objective: Stent fracture is a risk factor for stroke. It has not been fully elucidated whether stent-in-stent procedures can effectively treat stent fractures.

Case Presentation: An 80-year-old man underwent carotid artery stenting (CAS) with an open-cell stent to treat asymptomatic right internal carotid artery (ICA) stenosis. Type III stent fracture occurred during CAS. Six months later, in-stent stenosis progressed on DSA. Repeat CAS with a closed-cell stent was performed. CT showed expansion of the narrowed lumen. The patient remained stroke-free and carotid artery restenosis did not occur for 3 years postoperatively.

Conclusion: Repeat CAS with a closed-cell stent is a viable treatment option for stent fracture.