Bridging Technique with a Stent Retriever for Iatrogenic Internal Carotid Artery Occlusion during Coil Embolization of a Ruptured Aneurysm

Objective: Iatrogenic arterial dissection is a rare complication in neuroendovascular procedures, with an incidence of 0.15%–0.4% in the cervical carotid artery. In ruptured aneurysm cases, preoperative antiplatelet therapy is usually not administered, and immediate carotid artery stenting (CAS) in the event of occlusive dissection may lead to thrombosis. Even when antiplatelet drugs are administered urgently, their delayed onset may lead to in-stent thrombosis, resulting in cerebral ischemia. We report a case of intraoperative iatrogenic internal carotid artery (ICA) occlusion during coil embolization for a ruptured aneurysm, successfully managed by temporary flow restoration using a stent retriever until antiplatelet efficacy was achieved.