Recurrent stenosis of common carotid-intracranial internal carotid interposition saphenous vein bypass graft caused by intimal hyperplasia and treated with endovascular stent placement. Case report and review of the literature.

Intimal hyperplasia is a well-known cause of delayed stenosis in vein bypass grafts in all types of vascular surgery. Options for treatment of stenosis in peripheral and coronary artery bypass grafts include revision surgery and the application of endovascular techniques such as balloon angioplasty and stent placement. The authors present a case of stenosis caused by intimal hyperplasia in a high-flow common carotid artery-intracranial internal carotid artery (IICA) saphenous vein interposition bypass graft that had been constructed to treat a traumatic pseudoaneurysm of the intracavernous ICA. The stenosis recurred after revision surgery and was successfully treated by endovascular stent placement in the vein graft. The literature on stent placement for vein graft stenoses is reviewed, and the authors add a report of its application to external carotid-internal carotid bypass grafts. Further study is required to define the role of endovascular techniques in the management of stenotic cerebrovascular disease.