Carotid stenting in a case of combined kinking and stenosis

Endarterectomy is currently the preferred treatment for severe carotid sten osis. The technique of eversion endarterectomy allows correction of severe vessel elongation and kinking. The latter is generally believed to be a rel ative contraindication for endovascular stent placement. We report successf ul percutaneous transluminal angioplasty and stenting of a left internal ca rotid artery with high-grade stenosis and severe kinking which was not amen able to endarterectomy because of the distal location of the stenosis. Adva nced stent technology with flexible materials makes endovascular treatment of carotid stenosis feasible even in cases of kinking.