Korean Circ J.  2011 Jul;41(7):405-408. 10.4070/kcj.2011.41.7.405.

Procedure-Induced Acute Common Carotid Artery Perforation Presenting With Airway Obstruction and Successful Treatment by Endovascular Stent Graft

• Lee CH
• Park JS
• Hwang KW
• Lee SW
• Park SW
• Park SJ

• KMID: 2225106
• DOI: http://doi.org/10.4070/kcj.2011.41.7.405

Abstract

A 63-year-old female was admitted to our hospital for catheter ablation during atrial fibrillation. After catheter ablation, the patient was transferred to the cardiac care unit and mechanically ventilated due to dyspnea and hypotension. Imaging showed active bleeding from the right common carotid artery (CCA) with extensive hematoma into the mediastinum. She was successfully treated with a stent graft at the CCA. Further bleeding or neurologic sequel did not occur after treatment.

Keyword

Carotid artery common; Stents; Endovascular procedure

MeSH Terms

Airway Obstruction
Atrial Fibrillation
Carotid Artery, Common
Catheter Ablation
Dyspnea
Endovascular Procedures
Female
Hematoma
Hemorrhage
Humans
Hypotension
Mediastinum
Middle Aged
Stents
Transplants

Figure

• 

  Fig. 1 CT of the neck after CCA injury. A: extravasation from CCA (arrow). B: extensive hematoma in the anterior cervical space with tracheal deviation. CCA: common carotid artery.

• 

  Fig. 2 Stent graft placement to treat an iatrogenic CCA injury. A: contrast material injection from the guiding catheter shows extravasation from the right CCA. B: stent graft with balloon catheter advancing to lacerated segment of the CCA. C: ballooning with stent graft and successful stent insertion. D: final angiogram shows successful sealing of perforation without blood-leakage. CCA: common carotid artery.

• 

  Fig. 3 Follow-up CT after treatment. A: stent graft without vascular leakage in right common carotid artery (arrow). B: markedly decreased amount of the soft tissue hematoma in the right lower neck.

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