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Branch retinal artery occlusion following carotid stenting: A case report
Ran Sun1, Xiao-Yan Peng2, Qi-Sheng You2
1Department of Opthalmology, Beijing Xuan Wu Hospital, Capital Medical University, Beijing 100053, P.R. China; Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100005, P.R. China.
Insights
Carotid artery stenting (CAS) can lead to retinal artery embolism, causing vision loss. Patients and neurologists must consider this serious complication and the need for ophthalmic evaluation after CAS.
Area of Science:
- Neurology
- Ophthalmology
- Vascular Surgery
Background:
- Carotid stenosis poses a risk for stroke.
- Carotid artery stenting (CAS) is a procedure to treat carotid stenosis.
- Post-procedural complications can significantly impact patient outcomes.
Purpose of the Study:
- To highlight the risk of retinal artery embolism following CAS.
- To emphasize the importance of ophthalmic evaluation post-CAS.
- To inform patients and clinicians about potential vision loss.
Main Methods:
- Case report of a 70-year-old male patient.
- Diagnosis of carotid stenosis and subsequent CAS.
- Monitoring for postoperative complications, including visual disturbances.
Main Results:
- Patient developed decreased visual acuity and visual field defects post-CAS.
- Diagnosis of retinal artery embolism confirmed.
- CAS-induced plaque shedding identified as the likely cause.
Conclusions:
- Retinal artery embolism is a serious complication of CAS.
- Ophthalmic evaluation is crucial after CAS to detect embolic events.
- Informed consent regarding the risk of permanent vision loss is imperative for patients undergoing CAS.
Abstract:
A 70 year old male was diagnosed with carotid stenosis and underwent carotid artery stenting (CAS). Severe postoperative complications arose subsequent to the procedure, including decreased visual acuity and symptoms of a visual field defect, and the patient was eventually diagnosed with retinal artery embolism. CAS reduces carotid plaque; however, the subsequent shedding of carotid plaque may cause retinal artery embolism, resulting in the serious loss of visual function in patients. This complication is of paramount importance and requires great consideration from the neurologist and the patients undergoing CAS. Ophthalmic evaluation is paramount following CAS due to the possibility of embolic occlusion of the retinal artery. It is imperative that patients be informed of the risk of permanent vision loss as a result of CAS.
