Document resource
Carotid stent fracture is an uncommon but increasingly recognized complication of carotid artery stenting (CAS), and its clinical implications remain controversial. We report a rare case of repeated carotid stent fracture occurring at the identical anatomical location in a 36-year-old female patient. After successful CAS for symptomatic carotid bulb stenosis, a high-grade stent fracture was detected on follow-up imaging without neurological symptoms and was initially managed conservatively. Progressive in-stent restenosis subsequently required repeat CAS using a stent-in-stent technique with the same stent platform. Despite reintervention, follow-up imaging demonstrated recurrent fracture at the same site, accompanied by focal severe restenosis. The lesion was ultimately treated with a closed-cell carotid stent, resulting in satisfactory luminal patency. This case highlights the limitations of the stent-in-stent approach in the presence of persistent focal mechanical stress and underscores the importance of individualized retreatment strategies and long-term imaging surveillance in selected patients after CAS.Disclosures S. Jin: None.