Endovascular management of bilateral traumatic internal carotid artery dissections: A case report

Traumatic carotid artery dissection is a rare vascular injury, with bilateral involvement exceedingly uncommon. A 53-year-old woman presented with bilateral internal carotid artery dissections after a high-speed motor vehicle collision. Despite initial antiplatelet therapy with aspirin, she developed delayed neurological deficits due to progressive stenosis. We successfully performed staged bilateral carotid stenting, 5 days apart, using self-expanding stents with distal protection after ensuring the stabilization of an associated cervical spinal epidural hematoma. This case demonstrates that early recognition and staged endovascular approach can effectively restore cerebral perfusion and prevent ischemic stroke in complex bilateral traumatic carotid artery dissection when initial hemorrhagic risks are present.