Timely Carotid Revascularization to Prevent Stroke After Left Common Carotid Artery Occlusion During TEVAR.

Authors

Iman Setiadi, Suko Adiarto

Published in

JACC. Case reports. Pages 110032. Aug 28, 2026. Epub Aug 28, 2026.

Abstract

Proximal thoracic endovascular aortic repair extension near the aortic arch may compromise supra-aortic branch perfusion.
A 41-year-old man with acute Stanford type B/DeBakey III aortic dissection had persistent chest pain despite anti-impulse therapy. A persistent type IA endoleak after the first thoracic stent graft required a second proximal extension. Completion angiography showed resolution of the endoleak but immediate loss of left common carotid artery opacification. Carotid duplex ultrasonography confirmed absent flow. Ultrasound-guided direct left common carotid artery access followed by chimney stenting restored antegrade carotid flow within 10 minutes, before any neurologic deficits developed.
Immediate recognition and rapid bailout revascularization can prevent disabling cerebral ischemia after inadvertent left common carotid artery compromise.
Supra-aortic branch patency should be confirmed after proximal thoracic endovascular aortic repair extension, with prompt carotid bailout when compromise is detected.

PMID:
42667287
Bibliographic data and abstract were imported from PubMed on 29 Aug 2026.

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