Carotid Artery Stenting for a Recanalized Carotid Artery Lesion: A Case Report

Abstract

Objective: We report a patient with symptomatic occlusion of the right internal carotid artery, showing recanalization and treated by percutaneous transluminal angioplasty and stenting.

Case presentation: A 78-year-old man presented with transient left homonymous hemianopsia. Magnetic resonance imaging showed infarction of the right anterior choroidal artery territory. Magnetic resonance angiography revealed occlusion of the right internal carotid artery and stenosis of the left internal carotid artery. We performed carotid artery stenting (CAS) for the left carotid artery. Four months later, carotid ultrasound imaging showed recanalization and stenosis of the right internal carotid artery. Therefore, we performed CAS for the right internal carotid artery. Because of complex and narrow lesion, we used not only distal filter protection and proximal protection, but also balloon protection for external carotid artery. The patient’s clinical course was uneventful, and he was discharged on the 8th postoperative day.

Conclusion: As acutely occluded carotid artery may recanalize, we need to follow-up the lesion. The triple protection system, we adopted, is useful for this kind of severe and long stenotic lesion.