title: Tandem balloon protection during emergency carotid artery stenting of a stenotic ICA lesion with intraluminal thrombus.
abstract: 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.
authors.affiliation: Department of Emergency Medicine, Acute Stroke Center, Kyoto First Red Cross Hospital, Higashiyama, Kyoto, Japan. keisuke@qb4.so-net.ne.jp
authors.forename: Keisuke
authors.initials: K
authors.lastname: Imai
authors.forename: Masahiro
authors.initials: M
authors.lastname: Makino
authors.forename: Fumitoshi
authors.initials: F
authors.lastname: Niwa
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Takegami
authors.forename: Hironori
authors.initials: H
authors.lastname: Koike
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Azuma
authors.forename: Fumiko
authors.initials: F
authors.lastname: Oshima
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Oda
authors.forename: Kiyohito
authors.initials: K
authors.lastname: Kakita
mesh_terms: 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