Lt. ICA Treated by Stent Implantation

- Operator : Jong-Young Lee

Lt. ICA Treated by Stent Implantation

- Operator: Jong-Young Lee, MD

Case Presentation

The patients was a 81 year-old man.He was admitted for recurrent episodes of syncope. His cardiovascular risk factor was angina, hypertension and ex-smoking. He was treated with coronary artery bypass graft about 13 years ago.

Baseline Angiography & MRA

Angiography showed a significant stenosis of left ICA (Figure 1). Brain MR/MRA showed concentric severe stenosis of left proximal ICA and mild eccentric stenosis of right proximal ICA bulb. Carotid Doppler showed 70% stenosis in left carotid bulb to proximal ICA.

Procedural Step

A 7Fr sized sheath was inserted into the right femoral artery. A distal embolic protection device (FilterWire EZ) was placed in the distal portion of left ICA. Pre-ballooing with an Aviator 4.0 x 30 mm sized balloon upto 4.0 (10 atm) was performed at left ICA( Movie 1) . And then, a 9.0 x 30 mm sized Carotid Wallstent was deployed( Movie 2). Adjunctive postdilation was performed with an Aviator 5.0 x 20 mm sized balloon upto 5.0 (10 atm). All procedure was uneventful. Final carotid angiogram showed good result with no residual diameter stenosis( Movie 3).