A case presenting with acute leg pain after carotid artery stenting

A 82-year-old male presented with trembling of upper right limb. The MRI showed carotid artery stenosis on his left side. He underwent percutaneous carotid artery stenting (CAS) via left transfemoral artery approach. The Angio-Seal ®, which is an arterial closure device was placed after the procedure. A few days after he was discharged, he had started complaining the cold feeling, the numbness and the pain in the rest of his left lower limb. The mobile lesion was observed by ultrasonography at this point. However, one month later, complete occlusion of left common femoral artery was detected by the follow up ultrasonography. Large collagen sponge was successfully removed using endoscopic forceps via retrograde popliteal artery approach and the blood flow was improved of left lower limb. The ultrasonography was found to be useful for distinguishing thromboembolism from collagen sponge.