Angioscopic Findings in 3 Patients Who Required Retreatment After Carotid Artery Stenting.

Abstract

BACKGROUND:

Use of angioscopy to directly observe the stent lumen in the chronic phase after carotid artery stenting (CAS) has not been reported to date. Here we report 3 patients in whom angioscopy helped confirm the stent lumen during retreatment after CAS.

CASE DESCRIPTION:

Case 1 required retreatment for stent shortening that occurred 1 month after the first CAS. Preprocedure angioscopy showed the presence of neointima, which could not be revealed by intravascular ultrasound (IVUS). In case 2, which required repeat CAS for distal progressive stenosis of the internal carotid artery, the neointima was observed on the stent surface and was more pronounced on the distal side. In case 3, retreatment was necessary for recurrent ischemic stroke caused by stent restenosis; preprocedure angioscopy showed an unstable plaque, which was not detected as vulnerable by IVUS, protruding into the stent lumen, with partial ulceration and bleeding.

CONCLUSIONS:

Compared with IVUS, angioscopy enables a more detailed observation of the stent lumen. Although angioscopy is relatively invasive, its use in evaluating changes in the stent lumen after CAS should be clarified by accumulation of reported cases.

• Authors: Hiroshi Kondo, Yoshihiro Kiura, Shinichiro Takeshita, Takuro Magaki, Tetsuhiko Sakoguchi, Tomoya Mukai, Yuyo Maeda, Atsushi Tominaga, Kaoru Kurisu
• Journal: World neurosurgery (World Neurosurg) Vol. 130 Pg. 358-363 (Oct 2019) ISSN: 1878-8769 [Electronic] United States
• PMID: 31279107 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2019 Elsevier Inc. All rights reserved.

Topics

• Aged
• Aged, 80 and over
• Carotid Artery, Internal (pathology, surgery)
• Carotid Stenosis (pathology, surgery)
• Computed Tomography Angiography
• Humans
• Magnetic Resonance Angiography
• Male
• Neointima
• Reoperation
• Stents
• Young Adult