Carotid transluminal angioplasty with evidence of distal embolization

A 57-year-old woman presented with symptomatic triple tandem stenosis of the left carotid artery. Transluminal angioplasty of an atherosclerotic stenosis at the origin of the common carotid artery was performed retrogradely through a distal arteriotomy after endarterectomy. The postangioplasty effluent was collected and analyzed. Cholesterol crystals and amorphous plaque debris were identified, indicating a source for distal embolization. The clinical significance of this small amount of debris embolizing to the intracranial circulation is uncertain, but should be of concern when considering angioplasty of the cerebral circulation.