[Stenting without prior dilatation in intracranial stenosis of the internal carotid artery: a case report].
BACKGROUND
Recent reports have described the application of coronary stents for the treatment of intracranial stenosis of the internal carotid artery (ICA), above all in patients who do not respond to medical treatment and display advancing neurological symptoms. Stenting in intracranial vascular lesions of the carotid territory has been used almost exclusively in the treatment of the complications due to transluminal angioplasties with balloons. In selected cases and without prior dilatation of the stenosis it would be possible to place a stent.


METHODS
We describe a case of intracranial carotid stenting, without previous dilatation, in a 57 year old male patient with multiple arteriosclerotic risk factors. The patient presented neurological symptoms with no response to medical treatment, caused by a stenosis that affected over 70% of the cavernous segment of the right ICA, which was shown up by the arteriographic study. A favourable anatomy and the material used allowed the stent to pass through the stenosis without the need for dilatation. No immediate complications were observed and the carotid artery was seen to be of a normal calibre for stenosis. The brain angiogram also proved to be normal. The patient continues with the medical treatment and has remained neurologically stable throughout the 9 month clinical follow up.


CONCLUSIONS
In certain selected cases, placing an intracranial carotid stent, without previous balloon dilatation, can give good results and prevent the complications that can accompany angioplasty (such as dissection, rupture or embolism)
Martínez Rodrigo
J J
JJ
Hospital Universitario Dr. Peset, Valencia, España. jmrod@airtel.net
Agramunt Lerma
M
M
Poyatos-Ruipérez
C
C
Taberner Andrés
P
P
Lonjedo Vicent
E
E
Ruiz Guanter
A C
AC
D002343:Carotid Artery, Internal; D016893:Carotid Stenosis / Q000601:surgery*; D006801:Humans; D015607:Stents