Symptomatic Carotid Near Total Occlusion Treated by Carotid Stenting
A 69 year old male presented with right upper and lower limb weakness for 10 days. He had a history of recurrent Transient Ischemic Attacks (TIA) for 3 years.
Diagnosis And Treatment
Doppler study revealed bilateral carotid artery stenosis (left >right). DSA revealed near total occlusion of left proximal cervical ICA with inadequate antegrade flow in left MCA territories. Percutaneous transluminal angioplasty with stenting of left ICA stenosis was performed using distal embolic protection device. Carotid wall stent was deployed and adequate antegrade flow in left MCA territories was restored. The patient was discharged with GCS of E4V5M6 and 5/5 power in all four limbs on second post operative day.
Fluro image showing ICA stent
Angiogram showing thin streak of flow in left proximal cervical ICA
Post stenting angiogram image showing normal caliber and flow restored in left ICA
Angiogram image showing very slow and inadequate antegrade flow in left MCA territories
Post stenting angiogram image reaveal normaladequate antegrade flow in left MCA territories
About Author –
Dr. Suresh Giragani, Consultant Neuro & Interventional Radiologist, Yashoda Hospitals - Hyderabad
MD (Radiology), DM (Neuroradiology)
Specialized in the comprehensive and widest range of vascular interventions covering neuro interventions, hepatobiliary interventions, venous, peripheral vascular interventions and interventions in cancer care.