We report 2 cases of stent-in-stenting for the plaque protrusion after stent deployment.
In 1 case, a 69-year-old male presented right hemispheric TIA. He had received radiation therapy for middle laryngeal cancer 10 years previously. Diagnostic cerebral angiography demonstrated bilateral severe cervical carotid artery stenosis. The patient was treated with bilateral carotid artery stenting (CAS). After his left CAS, angiography showed satisfactory results, but intravascular ultrasound (IVUS) imaging revealed a plaque protrusion through the struts of the stent. Six days after the procedure, protruded plaque grew bigger and moved rapidly. An additional stent was deployed in the first stent to seal it. The patient's clinical course was uneventful.
In the second case, a 58-year-old male with unstable angina had multiple major cerebral artery stenoses (bilateral carotid arteries, left subclavian artery). Before CABG, he received subclavian stenting. Although subclavian angiography showed satisfactory results, IVUS imaging revealed mobile plaque protruding through the struts of the stent. An additional stent was deployed in the first stent (stent-in-stenting) to seal it. The patient had no neurological sequelae.
