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Updated: Nov 7, 2025
A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
Stenting in High-Grade Internal Carotid Artery Stenosis: 2-Dimensional Operative Video
Joel M Kaye1, Juan C Mejia-Munne1, Aaron W Grossman2
1Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
Insights
Carotid artery stenting effectively treats high-grade carotid artery stenosis, reducing stroke risk. This case highlights a nuanced technique for challenging stent delivery in neuroendovascular surgery.
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.
Abstract:
Carotid artery stenosis is implicated in up to 40% of all ischemic strokes. Accordingly, symptomatic, high-grade carotid artery stenosis portends an especially high risk of future stroke. Intervention via open or endovascular approaches drastically reduces this risk. Under the appropriate conditions, carotid artery stenting serves as a safe and effective alternative to carotid endarterectomy. We present the case of a 57-yr-old male with symptomatic, high-grade stenosis of his right internal carotid artery, for whom a history of radiation to the head and neck represented a relative contraindication to carotid endarterectomy, and thus endovascular treatment with angioplasty and stenting was performed. Informed consent was obtained prior to the procedure. Intraprocedurally, stent delivery past the area of stenosis proved somewhat challenging. However, by employing several nuanced maneuvers, we utilized our guiding catheter in a nonconventional manner in order to successfully perform the procedure. As the field of neuroendovascular surgery evolves, each case provides us unique lessons, which in turn expands our interventional capabilities and adds to the armamentarium of neuroendovascular techniques. We present this surgical video both as a means to provide a general overview of carotid artery stenting, and to share a lesson learned through the implementation of an interesting technical nuance.
