Chronic total symptomatic carotid artery occlusion treated successfully with stenting and angioplasty.
OBJECTIVE
Treatment of symptomatic chronic totally occluded carotid artery has been limited to medical management. An ongoing clinical trial is examining the role of extracranial to intracranial bypass surgery in select patients with impaired cerebrovascular reserve based on PET imaging parameters. We describe a case utilizing stenting and angioplasty to treat a chronic total carotid occlusion as a potential alternative therapy.


METHODS
A 55-year-old woman presented with a right hemispheric ischemic stroke in the setting due to a right internal carotid artery total occlusion.


METHODS
She was treated medically with antiplatelet therapy and oral vasopressor agents. She returned with new symptoms 1 month later and was successfully treated with stenting and angioplasty. At the 9-month follow-up, she remains neurologically intact.


CONCLUSIONS
Stenting and angioplasty may be a therapeutic option in select patients with chronic total carotid occlusion. Further study is required to determine the safety profile of this treatment modality.
Bhatt
Archit
A
Department of Neurology, Michigan State University/Sparrow Health Systems, East Lansing, MI, USA.
Majid
Arshad
A
Kassab
Mounzer
M
Gupta
Rishi
R
D017130:Angioplasty / Q000379:methods*; D002545:Brain Ischemia / Q000209:etiology; D016893:Carotid Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008875:Middle Aged; D015607:Stents; D020521:Stroke / Q000209:etiology; D014055:Tomography, Emission-Computed