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[Bilateral carotid stenting for bilateral carotid artery stenosis improved vascular dementia]
Masaharu Sakoh1, Toshihiro Ueda, Yoshiaki Kumon
1Department of Neurological Surgery, Ehime University School of Medicine, Shizukawa, Shigenobu-cho, Onsen-gun, Ehime 791-0295, Japan.
Insights
Bilateral internal carotid artery stenosis, a condition causing severe blood flow reduction, was successfully treated with carotid stenting. This intervention improved cerebral blood flow and reactivity, resolving neurological deficits.
Area of Science:
- Neurology
- Vascular Surgery
- Interventional Cardiology
Background:
- Bilateral internal carotid artery (ICA) stenosis poses a significant risk for ischemic stroke and vascular dementia.
- Severe stenosis can lead to critically reduced cerebral blood flow (CBF) and impaired cerebrovascular reactivity (CVR).
Observation:
- A 78-year-old male presented with vascular dementia and left hemiparesis.
- Magnetic resonance angiogram (MRA) revealed bilateral ICA stenosis, confirmed by cerebral angiogram showing 88% stenosis on the right and 93% on the left.
- Xenon single-photon emission tomography (SPECT) demonstrated severely decreased CBF and CVR.
Findings:
- Bilateral carotid angioplasty with self-expanding stents was performed.
- Post-procedure, both CBF and CVR showed significant bilateral improvement.
- The patient was discharged with no neurological deficits.
Implications:
- Carotid stenting is a viable treatment option for severe, bilateral ICA stenosis causing cerebral ischemia.
- This case highlights the potential of endovascular intervention to restore cerebral perfusion and improve patient outcomes.
- Further research into stenting for bilateral carotid stenosis may refine treatment protocols for cerebrovascular disease.
Abstract:
We report a case of bilateral internal carotid artery (ICA) stenosis treated with stenting. A 78-year-old man suffered from vascular dementia and left hemiparesis, and, by magnetic resonance angiogram (MRA), was diagnosed as having bilateral ICA stenosis. Cerebral angiogram showed severe, bilateral ICA stenosis (right; 88%, left; 93%) and xenon single photon emission tomography (SPECT) showed severely decreased cerebral blood flow (CBF) and cerebrovascular reactivity (CVR). We performed bilateral carotid angioplasty with self-expanding stents. Both CBF and CVR were improved bilaterally after the operation. The patient was discharged without neurological deficits. Carotid stenting may be an alternative treatment for severe ischemia caused by severe, bilateral ICA stenosis.