Stenting: A New Approach to Carotid Dissection

A patient with bilaterally occluded internal carotid arteries had a right hemispheric stroke followed by a left cerebral infarction, secondary to dissection from fibromuscular dysplasia, seen also in the vertebral arteries. The occluded left carotid was reopened and stents placed, with apparent reestablishment of left hemispheric blood flow. The speech and other deficits resolved. Although its use is under investigation, percutaneous balloon angioplasty with stents may be an appropriate intervention when other measures do not prevent progressive ischemic events.