Successful stenting seven days after atherothrombotic occlusion of the intracranial internal carotid artery

Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists
Keisuke ImaiMasaki Watanabe

Abstract

To report a case of successful stenting after a subacute stroke. A 75-year-old man presented with sudden onset of right-sided weakness and difficulty speaking. Imaging revealed an occlusion of the left petrous to lacerum internal carotid artery (ICA) segment and slightly decreased cerebral blood flow in the left hemisphere; there were stenoses of the ostial and cavernous ICA segments on the right. On the seventh day after the stroke, he underwent protected carotid angioplasty of the left intracranial ICA occlusion to reduce the high risk of ischemic stroke owing to bilateral disease. An external arteriovenous shunt was established with an occluding balloon in the proximal ICA and a filter in the femoral vein. After protected balloon dilation of the ICA occlusion, a 3.5 x 18-mm balloon-expandable coronary stent was deployed across the residual stenotic segment. An intraluminal filling defect of the petrous ICA segment suggested an arterial dissection or intraluminal thrombus, so another 2 coronary stents were deployed. Macroscopically visible materials were captured in the filter. The patient had a good clinical course and was discharged without neurological deficits on the twelfth day after the stroke. Angiography at 3 months c...Continue Reading

References

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Citations

Dec 3, 2014·Cardiology Clinics·Yinn Cher Ooi, Nestor R Gonzalez
Oct 8, 2008·Clinical Neurology and Neurosurgery·Bradley A GrossBernard R Bendok
Feb 2, 2011·Stroke; a Journal of Cerebral Circulation·Thomas G BrottUNKNOWN American Academy of Neurology and Society of Cardiovascular Computed Tomography
Feb 2, 2011·Stroke; a Journal of Cerebral Circulation·Thomas G BrottUNKNOWN American Academy of Neurology and Society of Cardiovascular Computed Tomography
Jun 16, 2015·Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology·Dina Giese, Helge Rask-Andersen

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