A Case in Which Angioscopy Was Useful for the Evaluation of Plaque Protrusion during Carotid Artery Stenting

Hiroshi Kondo; Yoshihiro Kiura; Shigeyuki Sakamoto; Takahito Okazaki; Daizo Ishii; Katsuhiro Shinagawa; Nobuhiko Ichinose; Atsushi Tominaga; Kaoru Kurisu

doi:10.5797/jnet.cr.2016-0110

Case Reports

A Case in Which Angioscopy Was Useful for the Evaluation of Plaque Protrusion during Carotid Artery Stenting

Hiroshi Kondo, Yoshihiro Kiura, Shigeyuki Sakamoto, Takahito Okazaki, Daizo Ishii, Katsuhiro Shinagawa, Nobuhiko Ichinose, Atsushi Tominaga, Kaoru Kurisu

Author information

Hiroshi Kondo
Department of Neurosurgery and Neuroendovascular Therapy, Hiroshima Prefectural Hospital, Hiroshima, Hiroshima, Japan
Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Hiroshima, Japan
Yoshihiro Kiura
Department of Neurosurgery and Neuroendovascular Therapy, Hiroshima Prefectural Hospital, Hiroshima, Hiroshima, Japan
Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Hiroshima, Japan
Shigeyuki Sakamoto
Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Hiroshima, Japan
Takahito Okazaki
Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Hiroshima, Japan
Daizo Ishii
Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Hiroshima, Japan
Katsuhiro Shinagawa
Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Hiroshima, Japan
Nobuhiko Ichinose
Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Hiroshima, Japan
Atsushi Tominaga
Department of Neurosurgery and Neuroendovascular Therapy, Hiroshima Prefectural Hospital, Hiroshima, Hiroshima, Japan
Kaoru Kurisu
Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Hiroshima, Japan

Keywords: angioscopy, carotid artery stenting, plaque protrusion, intravascular ultrasonography, optimal coherence tomography

JOURNAL OPEN ACCESS

2017 Volume 11 Issue 10 Pages 547-552

DOI https://doi.org/10.5797/jnet.cr.2016-0110

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Abstract

Objective: A case in which angioscopy was useful for the evaluation of plaque protrusion during carotid artery stenting (CAS) is reported.

Case Presentations: The patient was a 67-year-old man. He presented with transient ischemic attacks and progression of bilateral internal carotid artery stenosis during a course of about 7 months. CAS was performed with dual protection using flow reversal system (modified Parodi method) and FilterWire EZ (Boson Scientific, Natick, MA, USA). After stent placement, plaque protrusion was detected by intravascular ultrasonography (IVUS) and optimal coherence tomography (OCT), and plaque protrusion and fluttering debris were also noted by angioscopy. Therefore, additional stenting was performed. Although the evaluation was difficult by subsequent IVUS or OCT, angiosopy revealed plaque protrusion and fluttering debris were both confirmed to be immobilized by the stents.

Conclusion: Since the vascular and stent lumens could be evaluated directly by the use of angioscopy, it may be useful for the examination of plaques and plaque protrusions particularly when multiple stents have been used.

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