Intracranial Aneurysm Complicated by Common Carotid Artery Infarction Following FDS Procedure

Flow-diverter stents (FDS) are widely used in the endovascular reconstruction of large, wide-necked intracranial aneurysms; their mechanism of action primarily involves altering the hemodynamics within the aneurysm to promote thrombus formation. They represent a highly promising device for the treatment of intracranial aneurysms. When treating aneurysms located in the anterior circulation, key branches may be covered by the flow-diverter stent. The incidence of occlusion in these branches has been reported in the literature; moreover, even when branch occlusion occurs, associated neurological deficits are extremely rare. However, postoperative occlusion of the common carotid artery following flow-diverter stent placement is also extremely rare in clinical practice. This paper reports a case of a patient who developed left common carotid artery occlusion following the implantation of a fine-mesh stent. One year after the placement of a Surpass Evovle Flow Diverter System fine-mesh stent, the patient presented with symptoms such as impaired limb movement during a follow-up examination. Cranial MRI revealed a left frontoparietal cerebral infarction. Following treatment with enteric-coated aspirin tablets, the patient’s symptoms improved, and they were discharged. The aim of this study is to analyze the mechanism of occurrence and the management process by combining intraoperative, postoperative imaging, and follow-up data, while reviewing the relevant literature to explore the risk factors, clinical characteristics, and prevention and treatment strategies for this complication.