Stenting in High-Grade Internal Carotid Artery Stenosis: 2-Dimensional Operative Video

Area of Science:

• Neurology
• Vascular Surgery
• Interventional Radiology

Background:

• Carotid artery stenosis contributes significantly to ischemic stroke incidence.
• Symptomatic, high-grade stenosis necessitates intervention to mitigate future stroke risk.
• Carotid endarterectomy and carotid artery stenting are established revascularization methods.

Purpose of the Study:

• To present a case of carotid artery stenting in a patient with symptomatic, high-grade internal carotid artery stenosis.
• To illustrate a successful endovascular approach in a patient with a relative contraindication to open surgery.
• To share a technical nuance employed to overcome challenging stent delivery.

Main Methods:

• The study involved a 57-year-old male with symptomatic, high-grade right internal carotid artery stenosis.
• Endovascular treatment including angioplasty and stenting was performed.
• A nonconventional guiding catheter maneuver was utilized to facilitate stent delivery.

Main Results:

• Successful angioplasty and stenting of the internal carotid artery stenosis were achieved.
• The technical nuance enabled overcoming intraprocedural challenges.
• The patient's stroke risk was effectively addressed through endovascular intervention.

Conclusions:

• Carotid artery stenting is a viable and effective treatment for select patients with high-grade stenosis.
• Adaptable interventional techniques are crucial for managing complex neuroendovascular cases.
• Each case contributes valuable lessons to the evolving field of neuroendovascular surgery.