Rt. Internal Carotid Artery Lesion Treated by Stent Implantation

- Operator : Hsien-Li Kao

Rt. Internal Carotid Artery Lesion Treated by Stent Implantation

- Operator: Paul Hsien- Li Kao, MD

Case Presentation

A 51 years old man was admitted for pre-syncope. He had history of angina pectoris and PCI. Carotid Doppler revealed increased peak systolic velocity (487 cm/sec) and 75% stenosis of Rt. carotid bulb and proximal ICA due to irregular surfaced low-echoic plaques.

Baseline MRA

Magnetic resonance angiography of the brain showed focal severe stenosis in right carotid bulb.

Procedural Step

The right femoral artery was punctured and a 5 Fr sheath was introduced. After insertion of the right Judkin-4 5 Fr diagnostic catheter, we performed carotid and cerebral angiography ( Movie 1, Movie 2, Movie 3, Movie 4). Then, we exchanged the diagnostic catheter into the right judkin-4 8 Fr SH guiding catheter and inserted the FilterWire EZ (embolic protection system) 0.014 inch 150 cm into the right internal carotid artery ( Movie 5). Next, we introduced and deployed the self-expandable carotid wall stent 9.0(30) at the right internal carotid artery ( Movie 6). Because of the residual stenosis, we performed post-stenting balloon dilatation by Aviator 6.0(20) ( Movie 7). Final carotid and cerebral angiography showed excellent blood flow through the right internal carotid artery ( Movie 8).