title: Contralateral microemboli following carotid artery stenting in patients with a contralateral internal carotid artery occlusion.
abstract: Subclinical microembolization identified on diffusion-weighted magnetic resonance imaging is recognized as an important outcome measure for carotid revascularization procedures. It is generally believed that arch manipulation is the primary reason for developing microemboli in the contralateral hemisphere during carotid artery stenting. However, we identified three patients who developed postprocedure microemboli of the contralateral hemisphere despite a known chronic contralateral internal carotid artery occlusion. Our cases highlight that ipsilateral microemboli may be an underappreciated but an important source of contralateral lesions through patent intracranial collateral pathways.
authors.affiliation: Department of General Surgery, Division of Vascular Surgery, Naval Medical Center San Diego, San Diego, CA, USA.
authors.forename: Kevin
authors.initials: K
authors.lastname: Casey
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Hitchner
authors.forename: Barton
authors.initials: B
authors.lastname: Lane
authors.forename: Wei
authors.initials: W
authors.lastname: Zhou
mesh_terms: D000368:Aged; D000800:Angioplasty, Balloon / Q000009:adverse effects* / Q000295:instrumentation*; D002343:Carotid Artery, Internal / Q000473:pathology / Q000503:physiopathology; D016893:Carotid Stenosis / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D002560:Cerebrovascular Circulation; D002941:Circle of Willis / Q000473:pathology / Q000503:physiopathology; D003097:Collateral Circulation; D038524:Diffusion Magnetic Resonance Imaging; D006801:Humans; D020766:Intracranial Embolism / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D018810:Magnetic Resonance Angiography; D008297:Male; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D015607:Stents; D016896:Treatment Outcome