Tandem balloon protection during emergency carotid artery stenting of a stenotic ICA lesion with intraluminal thrombus.
OBJECTIVE
To report a technique for emergency CAS of a stenotic internal carotid artery (ICA) lesion with an intraluminal thrombus, which predisposes to distal thromboembolism and could aggravate pre-existing neurological symptoms.


METHODS
A 77-year-old man with fluctuating stroke underwent successful emergency CAS for an ICA stenosis with intraluminal thrombus using a tandem balloon protection technique featuring proximal balloon blockade and a PercuSurge GuardWire system for distal protection.


CONCLUSIONS
This experience suggests that emergency CAS with tandem balloon protection is a potential treatment for a stenotic lesion with an intraluminal thrombus in patients with fluctuating stroke.
Imai
Keisuke
K
Department of Emergency Medicine, Acute Stroke Center, Kyoto First Red Cross Hospital, Higashiyama, Kyoto, Japan. keisuke@qb4.so-net.ne.jp
Makino
Masahiro
M
Niwa
Fumitoshi
F
Takegami
Tetsuro
T
Koike
Hironori
H
Azuma
Yumiko
Y
Oshima
Fumiko
F
Oda
Kenichiro
K
Kakita
Kiyohito
K
D000368:Aged; D000800:Angioplasty, Balloon / Q000379:methods*; D002343:Carotid Artery, Internal; D016893:Carotid Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D002533:Cerebral Angiography; D004632:Emergency Medical Services; D005374:Filtration / Q000295:instrumentation*; D006801:Humans; D020766:Intracranial Embolism / Q000150:complications / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D011474:Prosthesis Design; D015641:Radiography, Interventional; D012720:Severity of Illness Index; D015607:Stents; D020521:Stroke / Q000209:etiology* / Q000628:therapy; D013927:Thrombosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D016896:Treatment Outcome