Acute In-Stent Thrombosis after Carotid Angioplasty and Stenting: A Case Report and Literature Review

Interventional Neurology
Wei HuGuoPing Wang

Abstract

Based on the results of a recent randomized controlled trial, carotid artery stenting (CAS) was regarded as a relatively safe, less invasive treatment of internal carotid artery stenosis. However, cerebral thromboembolic events are the most common complications of CAS. Especially acute stent thrombosis following CAS will be fatal without prompt diagnosis and revascularization. We report a case of acute stent thrombosis in whom carotid revascularization was performed successfully via arterial thrombolysis and balloon postdilation. A 79-year-old man with hypertension was hospitalized for an episode of transient ischemic attack. Computed tomography angiography revealed subtotal occlusion in the left carotid artery. Aspirin (100 mg) and clopidogrel (75 mg) were administered daily for 5 days before the procedure. CAS was performed under local anesthesia. The first postprocedural angiogram showed the stent looked good. However, a repeat angiogram showed in-stent thrombosis 2 min after withdrawal of the cerebral protection filter. Interestingly, the patient presented no neurologic deficit. After an additional 2,000 U of heparin had been administered intravenously, a microcatheter (SL-14; Boston Scientific, USA) was positioned to the i...Continue Reading

Citations

Jul 6, 2019·Vascular and Endovascular Surgery·Karlo ToljanZdravka Poljaković
Mar 14, 2020·Progress in Retinal and Eye Research·Jong Suk LeeSe Joon Woo
Mar 23, 2021·The Journal of International Medical Research·Wei WeiZheng Li

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