Abstract
An 84-year-old male was admitted to our hospital with right common carotid artery rupture after an unsuccessful attempt at hemodialysis catheter placement in the right internal jugular vein. He was hemodynamically unstable (blood pressure 55/35 mmHg) and mechanically ventilated. His hematocrit had dropped from 38% to 23% in 3 hours. His computed tomogram (CT) of the chest showed extensive hemorrhagic infiltration around the right common carotid artery (Panel A, arrow), which expanded into the mediastinum. Leak of the artery with pseudoaneurysm formation, angiographically proven (Panel B), was successfully excluded with selfexpanding covered stent placement (Panel C). The patient was transferred to the intensive care unit where his hematocrit and hemoglobin stabilized. He had a complicated post-procedural course, and ultimately succumbed 5 days later to respiratory and metabolic complications. Emergent carotid artery stenting has been reported in cases of acute carotid dissection with or without associated pseudoaneurysm, as well as in blunt carotid injury, and once in perforation complicating an elective carotid
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