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Patient presents with neck discomfort. No prior trauma, corticosteroid/opiod regimen or carcinoma is report. Prior neck surgery is noted. 

What do you see?



Aortic knob & mid thoracic spondylosis is present.

The closeup examination shows a vertical tubular mesh-like density adjacent to the left C1-2 facet joint.  

This is DACRON sleeve insertion into the left carotid artery.


 ICA dissection is secondary to a tear of the intima. The annual incidence of cranio-cervical dissections is 5 cases/100, 000 patient. 1 Within 6-12 months post surgery, Dacron sleeve are associated with higher incidence of recurrent stenosis. 2



  2. Clinical Trial J Vasc Surg 2004 May;39(5):985-93; discussion 993. doi:.1016/j.jvs.2004.01.037.