Delayed tine Displacement of a CASPER Carotid Artery Stent due to Styloid Process Compression

  • Daren TanEmail author
  • Matthew Thomas Crockett
  • Albert Ho Yuen Chiu


Eagle syndrome results from an elongated styloid process or calcified stylohyoid ligament causing impingement [1, 2]. This interaction causes injury to the carotid artery which may result in pseudoaneurysm, dissection or focal stenosis [1]. A similar interaction may occur when carotid stents are placed due to the alteration in biomechanics.

Stent fracture and deformation have been reported for laser-cut stents, with overall rates of fracture and deformation ranging from 3% at 1 year, to 50% at 4 years, and this can be complicated by restenosis in up to 36% [3, 4]. Fractures are associated with densely calcified arteries, angulated arteries and open cell stent designs [3, 4, 5]; however, most published case series are based on stents in the proximal internal carotid artery and carotid bulb, a location which experiences high torsional strain and has exposure to external compression [3, 4, 5].

The CASPER (Microvention Terumo, Aliseo Viejo, CA, USA) carotid stent is a woven...


Compliance with ethical guidelines

Conflict of interest

D. Tan, M. Crockett and A.H.Y. Chiu declare that they have no competing interests.

Ethical standards

All procedures reported in this article were in accordance with the ethical standards of the National Health and Medical Research Council Australia and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The patient provided informed consent for publication of images and text regarding the medical condition.


  1. 1.
    Yıldırımyan N, Daloğlu M, Sindel A, Altay MA. From diagnosis to treatment: eagle syndrome. J Otolaryngol ENT Res. 2017;8:1–3.CrossRefGoogle Scholar
  2. 2.
    Murthy PSN, Hazarika P, Mathai M, Kumar A, Kamath MP. Elongated styloid process: an overview. Int J Oral Maxillofac Surg. 1990;19:230–1.CrossRefGoogle Scholar
  3. 3.
    Coppi G, Moratto R, Veronesi J, Nicolosi E, Silingardi R. Carotid artery stent fracture identification and clinical relevance. J Vasc Surg. 2010;51:1397–405.CrossRefGoogle Scholar
  4. 4.
    Chang CK, Huded CP, Nolan BW, Powell RJ. Prevalence and clinical significance of stent fracture and deformation following carotid artery stenting. J Vasc Surg. 2011;54:685–90.CrossRefGoogle Scholar
  5. 5.
    Ling AJ, Mwipatayi P, Gandhi T, Sieunarine K. Stenting for carotid artery stenosis: Fractures, proposed etiology and the need for surveillance. J Vasc Surg. 2008;47:1220–6.CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Neurological Intervention & Imaging Service of WA [NIISwa], SCGH, RPH & FSH, Department of HealthNedlandsAustralia
  2. 2.UWA Medical School, Division of MedicineUniversity of Western AustraliaCrawleyAustralia

Personalised recommendations