Carotid Stent Thrombosis

Background —Carotid stenting is receiving increased attention as an alternative to carotid endarterectomy. Carotid stent thrombosis is a rare complication of this procedure.Case Descriptions —We present 2 case reports from a university medical center. Two patients had angiographically confirmed carotid stent (CS) thrombosis with subsequent fatal strokes. The first was a 63-year-old woman who developed stent thrombosis after the procedure was performed for a postendarterectomy intimal flap. The second patient was a 57-year-old man who underwent CS placement for transient ischemic attacks and developed internal carotid artery occlusion at the level of the stent 3 days later. Neither patient was treated with combination antiplatelet therapy before or after CS placement. Both patients died.Conclusions —CS thrombosis can be a cause of fatal iatrogenic stroke. Combination antiplatelet therapy should be administered to decrease the incidence of this complication.