We report an 84-year-old woman who underwent carotid artery stenting because of asymptomatic carotid artery stenosis. Perioperative monitoring by three-dimensional ultrasonography (US) revealed more than 80% stenosis in the right carotid artery. The patient initially had transient ischemic attacks manifested by dizziness and vertigo, and was diagnosed by carotid artery US at the brain dock. As intravascular treatment, carotid artery stenting was performed using the Angioguard XP filter protection device and Precise stent. Three-dimensiona] us and three-dimensional reconstruction of color Doppler sonography (CDS) enabled examination of carotid artery blood flow prior to surgery, as well as blood flow in the stent, and conditions of the grafted stent after surgery. Intravascular images, such as plaque shift or subacute thrombosis, were visualized in three spatial dimensions by a combination of three-dimensional US and standard two-dimensional US, indicating their benefit for the evaluation of intra-stent blood flow. On the other hand, two-dimensional US showed better performance in terms of plaque diagnosis, specifically for evaluation of the morphology and properties of plaques, than three-dimensional US. Further improvements in three-dimensional US including CDS systems are anticipated.
