• Lun-Xin Liu, Meng-Yuan Song, and Xiao-Dong Xie.
• Department of Neurosurgery, West China Hospital School of Basic Science and Forensic Medicine, Sichuan University, Chengdu, Sichuan, People's Republic of China.
• Medicine (Baltimore). 2017 Feb 1; 96 (7): e6101e6101.

UnlabelledIn-stent stenosis after treated by Willis covered stent-case reports.BackgroundAdvancements in minimally invasive technology have allowed endovascular reconstruction of internal carotid aneurysm. However, in-stent stenosis is an important and well-characterized complication of stenting after the treatment of internal carotid aneurysm.Case DescriptionWe would present 2 patients who were diagnosed with in-stent stenosis after the treatment of Willis covered stent. Case 1: A 57-year-old female with 2-week history of headache and vomiting before admission, whose digital subtraction angiography (DSA) demonstrated left internal carotid C6 aneurysm and showed about 20% stenosis 3 months later since operation in the position where Willis covered stent was deployed. Case 2: A 23-year-old male with skull base fracture, subarachnoid hemorrhage, right femoral fracture for 14 days and epistaxis for 9 hours caused by a car accident, whose DSA demonstrated left internal carotid paracliniod pseudoaneurysm. One year later, the patient went to our center again because he had headache and dizziness for 6 months after the interventional operation. His DSA demonstrated about 80% stenosis in the position where Willis covered stent was deployed. The clinical and radiologic characteristics and the experience in dealing with the stenosis are presented.ConclusionsIn-stent stenosis after treated with Willis covered is uncommon, but not rare. Operators should pay more attention to the in-stent stenosis during the period of follow-up observation and monitor P2Y12 Reaction Unit (PRU) in the antiplatelet period, especially for the Willis covered stent. What is more, the treatment for stenosis ought to be carefully considered.

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