title: Improved cerebral perfusion after simultaneous stenting for tandem stenoses of the internal carotid artery--two case reports.
abstract: Two patients with extracranial internal carotid artery (ICA) stenosis and tandem stenosis of the ipsilateral intracranial ICA were treated simultaneously by angioplasty with stenting. A 68-year-old man who presented with neovascular glaucoma had 90% stenosis of the right cervical ICA and 80% stenosis of the ipsilateral petrous ICA. A 74-year-old man who suffered from transient ischemic attack had 75% stenosis of the left cervical ICA and 90% stenosis of the ipsilateral cavernous ICA. Hemodynamic compromise was confirmed in both patients. Tandem stenting of both extracranial and intracranial ICA stenoses was performed simultaneously in both patients without complications. Poststenting angiography demonstrated excellent dilation of both lesions and normalization of cerebral perfusion. Simultaneous tandem stenting for extracranial ICA stenosis with intracranial tandem stenosis is less invasive than open surgery in high-risk patients with hemodynamic compromise, especially if the major lesion responsible for cerebral hypoperfusion is difficult to determine.
authors.affiliation: Department of Neurosurgery, Fukuoka University Chikushi Hospital, Chikushino, Fukuoka, Japan. tsutsumi@fukuoka-u.ac.jp
authors.forename: Masanori
authors.initials: M
authors.lastname: Tsutsumi
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Kazekawa
authors.forename: Akira
authors.initials: A
authors.lastname: Tanaka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Aikawa
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Nomoto
authors.forename: Kohei
authors.initials: K
authors.lastname: Nii
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Sakai
mesh_terms: D000368:Aged; D019917:Blood Vessel Prosthesis Implantation; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*; D002560:Cerebrovascular Circulation / Q000502:physiology*; D006801:Humans; D008297:Male; D011859:Radiography; D015607:Stents