title: Carotid angioplasty with stenting for chronic internal carotid artery occlusion: technical note.
abstract: BACKGROUND
  Carotid angioplasty with stenting (CAS) is becoming accepted as an effective and reliable treatment option for severe carotid artery stenosis. However, it is rarely applied for carotid occlusion, especially in its chronic stage. We report our experience of CAS for chronic internal carotid artery occlusion representing compromised cerebral blood flow using various protection methods.
  
  
  METHODS
  A 77-year-old woman, who was already diagnosed with severe left internal carotid artery stenosis, suddenly had right hemiparesis and aphasia. At that time, she was treated conservatively because her neurological status was quite good, in spite of left carotid artery occlusion. Her symptoms improved in the short term, except slight aphasia, but deteriorated again 18 days from the onset, and magnetic resonance imaging (MRI) showed new ischemic lesions. CAS was then performed for the occluded carotid artery on the 23rd day from the first onset.
  
  
  RESULTS
  Using the proximal protection technique, the occluded lesion was crossed carefully with a microguidewire. Stents were also placed successfully with the distal protection technique. The occluded carotid artery was completely recanalized without any unfavorable events or neurological deterioration.
  
  
  CONCLUSIONS
  In this patient, CAS was successfully to treat chronic carotid artery occlusion. These procedures and techniques are reviewed and discussed.
authors.affiliation: Department of Neurosurgery, Kainan Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Aichi, Japan. cbk71850@pop06.odn.ne.jp
authors.forename: Nozomu
authors.initials: N
authors.lastname: Kobayashi
authors.forename: Shigeru
authors.initials: S
authors.lastname: Miyachi
authors.forename: Kenichi
authors.initials: K
authors.lastname: Hattori
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Tanasawa
authors.forename: Takeshi
authors.initials: T
authors.lastname: Okada
authors.forename: Otone
authors.initials: O
authors.lastname: Endo
authors.forename: Naohito
authors.initials: N
authors.lastname: Yamamoto
mesh_terms: D000368:Aged; D017130:Angioplasty / Q000379:methods*; D002343:Carotid Artery, Internal; D016893:Carotid Stenosis / Q000628:therapy*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D015607:Stents