Acute ICA Dissection: Stent-Assisted Recanalization
A 48-year-old male presented with subarachnoid hemorrhage (Hunt and Hess Grade II, Fisher Grade III). Cerebral angiography revealed irregular broad-based projection from supraclinoid segment of the left internal carotid artery, suggesting a blister aneurysm (Fig. 93.1b). 3D rotational angiography was performed with a diagnostic catheter in ICA. Soon after the rotational run, patient had a seizure and became unconscious and had to be intubated. Repeat angiogram (Fig. 93.1d) revealed complete occlusion of left ICA with tapered margins giving rise to flame-like appearance, suggesting a possibility of dissection. AngioCT (DynaCT, Siemens, Germany) did not reveal any fresh intracranial hemorrhage.
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