Long-Time Delirium After Percutaneous Carotid Artery Stenting: A Case Report and Literature Review

There have been very few cases of delirium after carotid artery stenting (CAS). Particularly, no case of long-time delirium has been reported so far. This study will describe a case of long-term delirium in an elderly patient after CAS treatment and review the current literature. This report plans to make relevant medical workers pay more attention to the risk of delirium after CAS treatment, thereby providing deeper understanding and diagnostic guidance for clinical practice.

A 76-year-old male presented with ulcerative plaque and severe stenosis in the right internal carotid artery by femoral artery puncture angiography. The patient underwent CAS under embolization protection device (EPD) protection with local anesthesia. The surgery was successfully completed without any discomfort during the operation, but delirium appeared 7 h later. Magnetic resonance imaging (MRI) showed multiple intracranial arterial lacunar infarctions. Several transcranial Doppler (TCDs) tests suggested intracranial wide vasospasm that improved only when the condition improved. After several treatments, the symptoms of delirium improved after 60 days.

CAS may lead to the occurrence of long-term delirium. We should pay attention to it clinically, and take corresponding treatment measures once it occurs.