Sirolimus-eluting stenting of the external carotid artery for the treatment of ocular ischemia.
OBJECTIVE
To present a patient in whom severe external carotid artery (ECA) stenosis causing ocular ischemia was treated with a drug-eluting stent.


METHODS
A 55-year-old woman with severe, diffuse atherosclerosis presented with impaired left ocular perfusion and amaurosis fugax. Duplex ultrasonography and angiography documented bilateral occlusion at the origin of the internal carotid arteries, bilateral subtotal ECA stenoses, and subtotal distal left common carotid artery (CCA) restenosis following endarterectomy. Percutaneous revascularization of the left ECA and CCA stenoses was performed using a short coronary balloon-expandable sirolimus-eluting stent and a self-expanding nitinol stent, respectively. The procedure was uneventful, and the ocular symptoms resolved. At 6 months, the patient remained asymptomatic, with angiographically patent stents.


CONCLUSIONS
Drug-eluting stenting may be a novel option to treat symptomatic ECA stenosis.
Nussbaumer-Ochsner
Yvonne
Y
Department of Internal Medicine, University Hospital, Zurich, Switzerland.
Eberli
Franz R
FR
Baumgartner
Ralf W
RW
Landau
Klara
K
Roffi
Marco
M
D000497:Alloys; D020757:Amaurosis Fugax / Q000209:etiology / Q000601:surgery; D015901:Angiography, Digital Subtraction; D019917:Blood Vessel Prosthesis Implantation; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D016893:Carotid Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D020099:Coated Materials, Biocompatible / Q000627:therapeutic use*; D016894:Endarterectomy, Carotid; D005123:Eye / Q000098:blood supply*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007511:Ischemia / Q000209:etiology / Q000601:surgery*; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery; D012086:Reoperation; D020123:Sirolimus / Q000627:therapeutic use*; D015607:Stents; D014654:Vascular Patency
D000497:Alloys; D020099:Coated Materials, Biocompatible; D007166:Immunosuppressive Agents; C013616:nitinol; D020123:Sirolimus