[Carotid artery stenting using cerebral angiography 3D fusion imaging without contrast agent: a case report]

A 79-year-old-man with a clinical history of type 2 diabetes and hypertension was admitted to our hospital for recurrent right hemiparesis. He was referred to our department with left internal carotid artery stenosis. Cerebral angiography with a slight contrast agent revealed NASCET 86% stenosis at the left internal carotid bifurcation. Although no neurological deficit was observed, he had a renal dysfunction with an estimated glomerular filtration rate of 32.2 ml/min/1.73 m². We used a 3D fusion image obtained from the initial angiography with B-mode and intravascular ultrasound to avoid aggravating renal function instead of using a contrast medium. Following the procedure, favorable expansion of the stenotic region was achieved, and no evidence of recurrence was seen during the follow-up period. 3D fusion imaging is a valuable and safe method for endovascular treatment of carotid artery stenosis for patients with renal dysfunction.