Endovascular treatment of carotid stump syndrome.

Abstract

Carotid stump syndrome is a rare but recognized cause of cerebrovascular events. The syndrome is associated with carotid territory symptoms despite demonstration of occlusion of the ipsilateral internal carotid artery (ICA) on duplex ultrasound scans or angiograms. It is hypothesized that a residual stump of patent ICA is the source of emboli, which pass through the ipsilateral external carotid artery (ECA) into the middle cerebral artery circulation by way of reversed flow in the ophthalmic artery. To date all published cases of stump syndrome have been treated with surgical exploration and exclusion of the stump. We present the first case, to our knowledge, in which the stump was excluded with endovascular means with a covered stent.