Management of internal carotid artery pathology with a covered stent: illustrative cases

Background: Endovascular treatment of internal carotid artery (ICA) pathology includes reconstructive or deconstructive options. One reconstructive option is covered stent placement, although this is limited by a lack of devices designed specifically for neurointervention. The PK Papyrus is a balloon-mounted covered coronary stent that has a lower profile and is more flexible than other stent grafts, which makes it more suitable for treating ICA lesions.

Observations: The PK Papyrus was used to treat patients with iatrogenic cavernous ICA injury and symptomatic cervical ICA pseudoaneurysms. In both cases, the stent could be easily delivered without the use of an intermediate catheter or stiff microwire. Stent deployment resulted in immediate angiographic resolution of the pathology, and there were no peri- or postoperative complications.

Lessons: The PK Papyrus covered coronary stent is a good option for treating cervical and cavernous carotid pathology. Its single-layer design makes it more flexible and deliverable than other stent grafts, but additional case series are needed. https://thejns.org/doi/10.3171/CASE24517.