Stent deformation and intimal hyperplasia complicating treatment of a post-carotid endarterectomy intimal flap with a Palmaz stent.

We report a case of common carotid artery Palmaz stent placement for treatment of an intimal flap after surgical endarterectomy. Despite technical success with an excellent immediate result, a significant stenosis detected by duplex sonographic examination developed at 10 months. This stenosis, the result of stent compression and intimal hyperplasia, illustrates the previously theoretic risk associated with placement of the balloon-expandable stent in a compressible site such as the cervical carotid artery. In addition, we demonstrate that significant intimal hyperplasia may occur after carotid artery stent placement, potentially limiting long-term patency.