Key result
Carotid angioplasty and stenting successfully revascularized a subacute totally occluded internal carotid artery, leading to marked improvement in cerebral perfusion and cerebrovascular reserve capacity without recurrent stenosis at 3 months.
Case Report (n=1)
No
Carotid angioplasty and stenting may be a feasible and effective treatment for carefully selected patients with subacute internal carotid artery occlusion and restricted cerebrovascular reserve.
Supports feasibility of stenting in selected subacute ICA occlusion with poor reserve; hypothesis-generating and requires prospective confirmation.
While acute internal carotid artery (ICA) occlusions are increasingly being treated with carotid angioplasty and stenting (CAS), the utility of CAS in subacute stages is unclear. A 65-year-old patient with an acute left ICA occlusion and pre-existing occlusion on the right side presented with dysarthria and central right-sided facial palsy. Carbon dioxide (CO 2 ) reactivity within the left hemisphere was markedly reduced. Due to acute deterioration despite maximal conservative therapy CAS was performed 8 days after the initial event with an excellent result and symptoms subsided. CAS in subacute ICA occlusion is possible. Patients should be selected carefully. Assessment of cerebrovascular CO 2 reactivity might provide valuable information.
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Kallenberg et al. (2012) conducted a case report in Subacute occlusion of the internal carotid artery (n=1). Carotid angioplasty and stenting (CAS) was evaluated on Vessel patency and clinical outcome. Carotid angioplasty and stenting successfully revascularized a subacute totally occluded internal carotid artery, leading to marked improvement in cerebral perfusion and cerebrovascular reserve capacity without recurrent stenosis at 3 months.
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