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Vascular and Endovascular Surgery
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Iatrogenic Extracranial Carotid Dissection: Report of Two Cases Treated Surgically

Giorgio Tiberio

Department of Surgery, University of Brescia, Brescia, Italy

Stefano Maria Giulini

Department of Surgery, University of Brescia, Brescia, Italy

Luigi Cangiotti

Department of Surgery, University of Brescia, Brescia, Italy

Marco Floriani

Department of Surgery, University of Brescia, Brescia, Italy

Arianna Coniglio

Department of Surgery, University of Brescia, Brescia, Italy

Paolo Mulesan

Department of Surgery, University of Brescia, Brescia, Italy

Stefano Bonardelli

Department of Surgery, University of Brescia, Brescia, Italy

Two patients had an acute dissection of the right common carotid artery due to catheterization of the vessel during Seldinger angiography. Both patients were evaluated immediately after the traumatic event by means of echo-pulsed Dop pler (duplex scan) to check the hemodynamic significance of the lesion. In the first case, the lesion initially appeared insignificant, but on the second day duplex scanning showed a sudden reduction of the flow in the internal carotid artery due to progression of the carotid dissection: the patient, neurologically asymp tomatic, was operated on successfully.

The second patient, also asymptomatic, underwent emergency surgical treat ment after the first duplex scan showed significant reduction of the internal carotid flow. The postoperative course has been uneventful. Both patients are asympto matic eighteen and eight months after surgery.

The authors emphasize the important role that duplex ultrasonography played in the management of these 2 patients.

Vascular and Endovascular Surgery, Vol. 25, No. 6, 441-451 (1991)
DOI: 10.1177/153857449102500603
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