Abstract
We describe our experience with a patient who had a mobile plaque showing a jellyfish sign at the carotid bifurcation and an unstable plaque with severe stenosis at the origin of the internal carotid artery. Treatment with a statin decreased plaque mobility, allowing a stent to be safely placed.
Case report: A 71-year-old man. Examination before coronary artery bypass grafting revealed severe stenosis at the origin of the right internal carotid artery and a mobile plaque showing a jellyfish sign at the right carotid bifurcation. Carotid endarterectomy was considered high risk because of occlusion of the left carotid artery. Percutaneous transluminal angioplasty was performed to treat the stenosis at the origin of the internal carotid artery, avoiding the mobile plaque. Cerebral blood flow improved, but restenosis occurred and additional treatment was performed using the same strategy. After repeated restenosis, the mobility of the plaque at the bifurcation decreased. A stent was placed from the site of stenosis of the internal carotid artery to the common carotid artery, without any embolic complications, resulting in good dilatation.
Conclusion: We described a patient in whom endovascular therapy after administration of a statin was useful for the management of severe stenosis at the origin of the internal carotid artery, associated with a proximally located mobile plaque showing a jellyfish sign. Our experience suggests that statin treatment might reduce perioperative ischemic complications caused by carotid artery stenting in patients with mobile plaque showing a jellyfish sign.
