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

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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.