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Background: Although endovascular placement of covered stent grafts has emerged as the primary treatment modality for arterial aneurysms, pseudoaneurysms and traumatic arterial injuries especially in high risk patients and in those with surgically inaccessible lesions, their use in carotid pseudoaneurysms remains uncommon and is limited to case reports and small case series.
Case Description: One patient presenting with a spontaneous right carotid pseudoaneurysm was treated with Viabahn covered stents with no immediate perioperative complication and complete exclusion of his pseudoaneurysm on follow up imaging.
Methods: We conducted a systematic review of the English-speaking medical literature using the PubMed service and OVID Medline databases to identify all publications documenting the use of covered stents in the extracranial carotid pseudoaneurysms. The search included the keywords ‘Stents’ [Mesh] OR ‘Covered stents’ [Mesh] AND ‘Carotid Artery Pseudoaneurysm’[Mesh] NOT ‘Intracranial Arterial Diseases’[Mesh] NOT ‘Carotid-Cavernous Sinus Fistula’[Mesh] NOT Carotid Artery aneurysm’[Mesh]. The search results were further reviewed and filtered to include only case series and reviews with at least 5 cases.
Results: Our search yielded four publications that fulfilled these criteria.

Author	Year	Number of patients with carotid PSA	Stents used	Technical success	complications	Follow up
Saatci	2004	24	Jostent (24)	96%	None	6-24 mo
Yi	2008	9	Fluency(6) Jostent(2) Viabahn (1) iCast (1)	100%	Distal embolization (1)	5-25 mo
Hoppe	2008	9	Viabahn (5) Fluency (4)	100%	ICA dissection (1)	6-33 mo
Pulli	2013	5	Viabahn (3) Advanta (2)	100%	Type 1 endoleak	24 mo

Conclusion: Covered stents placement in carotid pseudoaneurysms is feasible and safe although larger studies evaluating the incidence of peri-procedural complications, long-term safety and stent patency are needed.