Efficacy of Bare Metal Carotid Stents for Cervical ICA Pseudoaneurysms

Introduction/Purpose Pseudoaneurysms of the cervical internal carotid artery (ICA) are uncommon lesions which have historically been treated with open surgical repair. In the endovascular era multiple options have been reported for vessel reconstruction including bare metal stents, flow diverting stents, covered stents and coil embolisation. The purpose of this study was to determine the technical success of using bare metal carotid stents for ICA pseudoaneurysms. Materials/Methods A retrospective single center case note review was conducted on all patients who underwent endovascular treatment for a cervical ICA pseudoaneurysm between 1/1/2018 to 6/30/2025. Cases were identified from a prospectively maintained institutional neurovascular database. All cases who underwent treatment with a bare metal carotid stent were included. Review of records including clinic letters, operative reports and radiological studies was conducted to extract data on clinical presentation, device usage, and radiological and clinical outcomes. Results Twelve patients (mean age 51.8 +/‐ 19.6 years, 7 male) were included. Five patients had no prior history of trauma. The indications for treatment were: ICA stenosis n=4, aneurysm growth n=4, ischemic events n=2 and aneurysm size n=2. A single stent was used in 9 cases and 2 telescoping stents in 3 patients. Radiological follow‐up was complete in 8 patients and 7 (87.5%) demonstrated complete resolution. Radiological follow‐up is pending in 3 patients and the remaining one died of COVID before follow‐up was due. No patients sustained new neurological deficits post‐procedure. Conclusion The results of this single center experience demonstrate that bare metal carotid stents are a safe and efficacious option for treating cervical ICA pseudoaneurysms. Their widespread use in atherosclerotic disease likely contributes to operator familiarity and the associated technical success seen in this series.