Symptomatic Carotid Near Total Occlusion Treated by Carotid Stenting
A 74 year old male presented with sudden onset slurring of speech and right sided weakness for 12 hrs.
Diagnosis And Treatment
MRI brain revealed acute infarct in left insula. MR angiography revealed non visualization of left ICA. DSA was done which revealed near total occlusion of left proximal ICA with inadequate antegrade flow in left MCA territories. The patient was treated with percutaneous transluminal angioplasty and carotid stenting using distal embolic protection device. C-Guard stent was deployed and adequate antegrade flow in left MCA territories was restored. The patient was discharged on 3rd post operative day with GCS of E4V5M6, normal speech and with 5/5 power in all four limbs.
Fluro image showing ICA stent
MRI-DWI image showing diffusion restriction in left perisylvian cortex
MR angiogram revealed nonvisualisation of left ICA
DSA (AP view) showing near total occlusion of left proximal cervical ICA with very slow and inadequate antegrade flow
Post stenting normal caliberand flow in left ICA established
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.