fig 3.

A 51-year-old man (patient 5) with a 10-day history of left-sided TIAs now presents with sudden onset of aphasia and right hemiparesis. Axial T1-weighted contrast-enhanced MR imaging shows a left frontal infarct (A). Digital subtraction angiography of the left common carotid artery showed progression of a left internal carotid dissection from a partial stenosis, 2 days prior, to a complete occlusion despite systemic anticoagulation (B). Digital subtraction angiography of the right common carotid artery revealed a dissection of the right internal carotid artery with an associated long-segment stenosis and an expansile pseudoaneurysm at the distal end (C). A Rapid Transit microcatheter was used to navigate the patent lumen of the right internal carotid artery and to deploy three Wallstents (6 mm × 45 mm, 7 mm × 20 mm, and 8 mm × 20 mm) in a tandem overlapping fashion with postdeployment balloon angioplasty (D). The procedure resulted in reconstitution of the normal lumen of the right internal carotid artery (E)