Abstract
A 75-year-old man presented with left hemiparesis, which had been preceded by recurrent left hand clumsiness that lasted for one hour. MRI detected multiple embolic lesions in his right cerebral hemisphere. He had a severe grade of right internal carotid stenosis (NASCET 80%). The cranial end of the lesion was located at the level of the second cervical vertebra. Carotid endoarterectomy partially left the plaque, which was confirmed by angiography in situ. The residual lesion was treated by transcervical filter-protected carotid stenting. During the initial passage of the filter device through the lesion, the arterial blood was aspirated transiently to collect the debris. Postoperative diffusion weighted MRI did not detect new embolic lesions and 10 days after the operation, the patient was discharged with a decrease of modified Rankin score from 4 to 0.
