Journal of Neuroendovascular Therapy
Online ISSN : 2186-2494
Print ISSN : 1882-4072
ISSN-L : 1882-4072
CASE REPORTS
Two Patients with Reversible Cerebral Vasoconstriction after Carotid Artery Stenting
Yoichi YoshidaEiichi KobayashiMasaaki KubotaAkihiko AdachiYasuo Iwadate
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JOURNAL OPEN ACCESS

2022 Volume 16 Issue 2 Pages 106-115

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Abstract

Objective: We herein report two cases of transient cerebral vasoconstriction after carotid artery stenting (CAS).

Case Presentation: An 81-year-old man presented with asymptomatic severe stenosis in the right carotid artery accompanied by a slight reduction in cerebrovascular reactivity. CAS was performed, but the patient had a generalized seizure because of transient cerebral ischemia caused by intolerance to carotid artery occlusion with balloon protection. Confusion and left hemiparesis persisted. DSA suggested cerebral ischemia due to vasoconstriction as the cause of these prolonged symptoms. A 66-year-old man presented with asymptomatic severe stenosis in the right carotid artery with slight hypoperfusion. CAS was performed. The patient developed left hemispatial neglect, dysarthria, and left hemiparesis 12 hours after the procedure. DSA revealed cerebral vasoconstriction in the responsible territory. The conditions of both patients improved within several days with medical treatment and they were discharged without neurological deficits.

Conclusion: The cases presented herein show that transient ischemic complications caused by cerebral vasoconstriction may develop after CAS.

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© 2022 The Japanese Society for Neuroendovascular Therapy

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