Two cases of carotid artery stenting in patients with recurrent cerebral embolism caused by a carotid web

Abstract

Case 1 is a 55-year-old male. Five months after an embolism in the right cerebral hemisphere, he developed a recurrent embolism in the same vascular territory. Carotid web embolism was diagnosed by CT angiography of the carotid artery, which showed a shadow defect in the right internal carotid artery. Percutaneous stenting was performed 14 days after the recurrence. The patient was discharged home with mRS 0 on postoperative day 14. Case 2 is a 48-year-old woman. Three years and three months after the onset of embolism in the right cerebral hemisphere, consciousness disorder appeared. Mechanical thrombectomy was performed. The patient underwent percutaneous stenting 27 days after recurrence with a diagnosis of embolism caused by a carotid web. She was discharged home with mRS 0 on postoperative day 9. Carotid web has been reported to be a cause of cerebral infarction in young patients without risk factors for atherosclerosis. In the past, CEA was often performed to prevent recurrent embolism, but CAS has been increasingly reported in recent years. We review the past CAS cases including these two cases.