Emergency carotid endarterectomy with stent retrieval in a patient with stent migration following failed carotid artery stenting

Carotid artery stenting (CAS) has become a favoured alternative to surgical carotid endarterectomy (CEA) in select cases of critical internal carotid artery (ICA) occlusion. However, complications such as stent migration or entrapment can occur, necessitating prompt diagnosis and intervention. We present a case of a 75-year-old diabetic male who underwent CAS for recurrent presyncope at a private hospital, and during the procedure of CAS the stent was migrated and its proximal part was impacted in the critically narrowed part of the ICA. The operating team failed to retrieve the stent and due to the unavailability of a vascular surgeon at their center, the patient was referred to us for stent retrieval and CEA. The patient underwent emergency carotid stent extraction and CEA with autologous saphenous vein graft patch reconstruction of ICA. His postoperative course was uneventful and the patient was discharged home on the 5th postoperative day. This case highlights the significance of multidisciplinary decision-making and prompt intervention in optimizing patient outcomes.