A bare covered stent

A 60 year old man had undergone cervical radiotherapy and lymphadenectomy for a metastatic epidermoid carcinoma 8 months ago. During follow up, there was persistent tissue necrosis around the carotid bifurcation. To prevent carotid disruption and also maintain cerebral perfusion, two self expandable covered stents (7 × 50 mm and 7 × 25 mm; Viabahn, Gore, Flagstaff, AZ, USA) were placed from the common to the internal carotid arteries. Ten days later, continuous neck bleeding occurred; computed tomography angiography showed good stent coverage surrounded by major tissue disruption and bleeding from the external circuit.