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Case report
Acute carotid stenting for treatment of stuttering transient ischemic attacks after recent carotid endarterectomy
  1. Vinodh T Doss1,
  2. Adam S Arthur2,
  3. Clarence Watridge2,
  4. Lucas Elijovich1,2
  1. 1Department of Neurology, University of Tennessee Health Science Center, Memphis, Tennessee, USA
  2. 2Department of Neurosurgery, Semmes-Murphey Clinic/University of Tennessee, Memphis, Tennessee, USA
  1. Correspondence to Dr L Elijovich, Department of Neurosurgery, Semmes-Murphey Clinic, 6325 Humphreys Blvd, Memphis, TN 38120, USA; lelijovich{at}semmes-murphey.com

Abstract

Carotid endarterectomy (CEA) is the established standard to treat occlusive extracranial atherosclerotic carotid disease. Complications of CEA must be recognized and dealt with efficiently due to the potentially catastrophic neurologic sequelae. A 67-year-old African American man was transferred from an outside hospital for an acute stroke. He had initially presented with a small right frontal subcortical infarct and had undergone a right CEA 2 days prior to transfer. He had a fluctuating examination with left-sided hemiplegia to slight hemiparesis and inconsistent neglect. Head CT demonstrated a watershed infarct of the right hemisphere. CT angiography demonstrated high grade stenosis at the distal aspect of the CEA anastomosis. He was promptly taken for angiography and underwent acute stenting of the right internal carotid artery. This case demonstrates that carotid artery stenting is a safe management strategy for the treatment of complications associated with failed distal anastomosis during CEA.

  • Stroke
  • Atherosclerosis
  • Artery
  • Stenosis
  • Stent

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