ArticleJournal of neuroendovascular therapy2026
Delayed Pseudoaneurysm Formation after Carotid Artery Stenting in a Heavily Calcified Lesion: A Possible Mechanism of Mechanical Vessel Injury.
Article in Journal of neuroendovascular therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: Pseudoaneurysm formation after carotid artery stenting (CAS) is a rare but potentially life-threatening complication. Herein, we report a case of delayed pseudoaneurysm formation associated with a heavily calcified lesion and discuss the possible underlying mechanisms. Case Presentation: An 87-year-old man presented with symptomatic left carotid artery stenosis. Carotid ultrasonography demonstrated a heavily calcified plaque without marked flow acceleration, and DSA revealed 69% stenosis according to the North American Symptomatic Carotid Endarterectomy Trial (NASCET) criteria. CAS was performed without any immediate complications. One month after the procedure, the patient developed a progressive swelling in the left cervical region. Ultrasonography and DSA revealed a pseudoaneurysm at the proximal edge of the stent accompanied by stent shortening. The lesion enlarged rapidly and caused tracheal compression, necessitating urgent intervention. Stent-assisted coil embolization was then performed. Although complete obliteration was not achieved, residual flow with marked stagnation was observed, and the cervical swelling gradually improved. Conclusion: Mechanical stress caused by balloon dilation of heavily calcified plaques may lead to arterial-wall injury and subsequent pseudoaneurysm formation. Rigorous monitoring is crucial when performing CAS for severely calcified lesions.
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