Management of acute internal carotid artery dissection during endovascular procedures: a case report
Luis Gustavo Biondi Soares, Breno Nery, José Alencar de Sousa Segundo, Mateus Wendler Ferreira Lopes, Emilly Beatriz Aleixo Almeida, José Diogo Medeiros dos Santos, Joyce Maria Menezes Grangeiro, Mayra Frederico de Menezes, Jamyle Grescy dos Santos Oliveira, Victor Vieira Soares, Leandro Assis Barbosa
Abstract
Dissection of the internal carotid artery (ICA) is a serious complication associated with invasive procedures such as angiography and cervical surgery. It occurs when injury to the ICA wall causes separation of arterial layers and interruption of blood flow, potentially leading to neurological complications such as stroke. The dissection may not be visible on immediate angiography and can occur without evident signs. Treatment options include antithrombotics or endovascular intervention. We report a 58-year-old female patient with systemic arterial hypertension and previous subarachnoid hemorrhage, admitted for cerebral arteriography. During the procedure, a dissection was identified in the cervical segment of the right ICA, absent in prior exams. Urgent mechanical thrombectomy was performed, achieving complete recanalization. Angioplasty with a 4.5 × 50 mm LEO stent restored blood flow. The patient progressed well, with no immediate neurological changes, and was transferred to the ICU for monitoring. This case emphasizes the importance of rapid recognition and treatment of ICA dissection to prevent serious sequelae. Careful clinical practice and meticulous endovascular techniques are essential to improve safety and ensure better outcomes.
Keywords
References
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Submitted date:
02/07/2026
Accepted date:
02/24/2026
Publication date:
03/24/2026
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