Central retinal arterial embolization after carotid artery stenting in the carotid stenosis

Abstract

Objective: We report a case of central retinal artery embolization just after carotid artery stenting (CAS).
Case presentation: A 74-year-old man presented with severe asymptomatic right internal carotid artery stenosis. After informed consent was given, CAS was performed for stenosis of the right internal carotid artery using distal filter and flow reversal devices. Immediately after CAS, the patient complained of blurred vision in the right eye. The following day, right fundoscopy revealed ischemic retinal whitening and a fluorescein angiogram showed no filling of the retinal arteries. One month later, examination revealed no improvement in right visual acuity and visual field defect.
Conclusion: Central retinal artery embolization during CAS is rare but should be kept in mind as a serious complication even when embolic protection (including use of a flow reversal method) is provided.