Transcarotid artery revascularization for carotid pseudoaneurysm and patch degeneration after carotid endarterectomy.

An 86-year-old man with a history of right internal carotid artery occlusion and two remote left carotid endarterectomies presented with a contained posterior rupture of a carotid pseudoaneurysm. The infectious workup was negative. He underwent transcarotid artery revascularization, including external carotid artery coil embolization and exclusion of the carotid aneurysm with a self-expandable stent graft. He was discharged home on postoperative day 1 with his home antiplatelet and anticoagulant therapy. The 3-month postoperative imaging study demonstrated a widely patent carotid stent without an endoleak. Transcarotid artery revascularization is a viable alternative to open repair or transfemoral stenting for carotid artery aneurysms.