Two cases of acute staged angioplasty for progressive stroke with carotid artery severe stenosis

Abstract

Progressive stroke has generally a poor prognosis and is sometimes difficult to treat. In cases of resistance to best medical treatment, surgical treatments such as carotid artery stenting (CAS) have been considered. Emergent CAS is associated with a risk of hemorrhage due to hyperperfusion. When the symptom is gradually worsening, percutaneous transluminal angioplasty is performed at first, followed by CAS after approximately 24 hours. In this study, hyperperfusion was not observed in both cases, indicating that this treatment strategy improves neurological outcomes.