Bilateral carotid stenting after a motor vehicle crash.

Extracranial carotid artery dissection after blunt trauma may manifest as arterial stenosis or occlusion or as dissecting aneurysm formation. Anticoagulation and/or antiplatelet therapy is the first-line treatment, but, because it is effective and less invasive than other procedures, endovascular treatment of carotid artery dissection has recently attracted interest. A small subset of patients with blunt carotid dissection, or pseudoaneurysms, have bilateral injuries which may be high risk for occlusion and ischemic stroke. Early carotid stenting and subsequent antiplatelet therapy may be an option in this patient group.