Rescue stenting for subacute thrombosis after carotid stenting-Report of 2 cases

Abstract

Acute revascularization of carotid artery occlusion after carotid artery stenting (CAS) remains controversial. This report describes successful revascularization by the deployment of rescue stents in two patients with subacute in-stent thrombosis (SAT) of internal carotid arteries (ICA) that had become re-occluded. The postoperative courses of both patients were uneventful, and the patency of the ICA was confirmed at follow-up one year later. The development of SAT in these two patients might have been due to insufficient antiplatelet therapy. We used proximal and distal balloon catheters as protection devices during all procedures and subsequently aspirated clots. Rescue stent-in-stenting is an effective alternative treatment for SAT if all clots can be safely removed under absolute carotid protection without migration into the brain.