Slides
Elective Carotid Artery Stenting in an Octogenarian Patient with Chronic Obstructive Pulmonary Disease
- Operator : Seong-Wook Park
| Elective Carotid Artery Stenting in an Octogenarian Patient with Chronic Obstructive Pulmonary Disease |
| - Operator : Seong-Wook Park, MD |
| Clinical information |
| The patient was an 82 year-old male with chronic obstructive pulmonary disease. Risk factors included hypertension. He had had an embolic stroke in 2002, after which neurologic deficit was normalized. Duplex Doppler study showed 75% stenosis of the left proximal internal carotid artery. Magnetic resonance angiography showed a mild stenosis involving the right internal carotid artery and severe stenosis of the left internal carotid artery. High mortality and morbidity following carotid endarterectomy was expected in this patient because of old age and coexisting disease. |
| Pre-intervention carotid angiography |
| Pre-intervention carotid angiography revealed tight stenosis of the proximal left internal carotid artery and mild stenosis of the right internal carotid artery (Figure 1). |
| Interventional procedure |
| Selective cannulation of the left common carotid artery was performed using a 5F Headhunter catheter. After cannulation, 0.035 stiff wire was inserted into external carotid artery. An 8Fr, 90-cm long, shuttle sheath was positioned in the left common carotid artery over the stiff wire. The lesion was predilated with 4.0 x 20 mm at 6atm (Figure 2). A self-expanding, 8mm x 41mm, carotid Wallstent was positioned and expanded from the left common carotid artery lesion to the internal carotid artery following predilation (Figure 3) Following angiogram, which revealed moderate stenosis of intrastent portion. Adjunctive balloon dilation was performed with a 7.0mm x 20mm balloon at 10 atm (Figure 4). The final result is shown in Figure 5. The hospital course was uneventful. |
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