A 45-year-old patient was evaluated in September 2000 for left hemiparesis.
His history included smoking, hypertension, hypercholesterolemia, peritonitis at 18 years of age and myocardial infarction in 1999.
After performing CT and MRI, a cerebral angiography showed occlusion of the right internal carotid artery and 60% stenosis associated with pseudoaneurysm in the left cervical tract, with signs of dissection in the MRI.
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Contralateral supplementation was found.
A median right common femoral approach was used to implant a single-rooted metallic endoprosthesis (Carot directed carotid artery of the Boston Scientific Co.) in the area of the stenosis that also extended over the left cervical area.
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A microcatheter was implanted through the mesh of the endoprosthesis with the GDC (Boston Scientific Co.), free of migration risk.
Post-procedure angiographic control showed recovery of light in the stenotic zone and absence of filling of the pseudoaneurysm.
During the procedure, 5000 IU of sodium heparin were administered.
Sequential anticoagulant therapy was performed in the acute phase with continuous sodium heparin, followed by dicumarins and subsequently platelet perfusion.
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After three years of evolution, angiographic and echocardiographic controls demonstrated patency of the treated artery without recurrence of the pseudoaneurysm; the patient did not present neurological symptoms in the left carotid territory.
