title: Reocclusion and stroke due to immediate plaque protrusion following endovascular treatment of carotid artery successfully treated with intra-arterial urokinase and stent in stent in a patient with Takayasu arteritis with severe disease of all arch vessels.
abstract: Endovascular treatment is becoming a safe and efficacious modality in the management of carotid artery stenosis in Takayasu arteritis (TA). A 24-year-old woman of TA presented with blurred vision, recurrent syncope and upper limb claudication. Angiography revealed right CCA 95 %, left CCA 90 % stenosis and occlusion of other arch vessels. She underwent right CCA angioplasty and stenting. She developed left-sided hemi paresis. Check angiogram revealed plaque protrusion in the proximal part of the stented segment. Intra-arterial urokinase bolus was given and overlapping stenting done. Re-occlusion by plaque protrusion immediately after stenting like in our case is not reported.
authors.affiliation: Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, 560069, Karnataka, India.
authors.forename: B C
authors.initials: BC
authors.lastname: Srinivas
authors.forename: Soumya
authors.initials: S
authors.lastname: Patra
authors.forename: Babu
authors.initials: B
authors.lastname: Reddy
authors.forename: C M
authors.initials: CM
authors.lastname: Nagesh
authors.forename: C N
authors.initials: CN
authors.lastname: Manjunath
mesh_terms: D002339:Carotid Arteries / Q000473:pathology; D016893:Carotid Stenosis / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D023903:Coronary Restenosis / Q000209:etiology*; D057510:Endovascular Procedures / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015607:Stents; D020521:Stroke / Q000209:etiology*; D013625:Takayasu Arteritis / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D014568:Urokinase-Type Plasminogen Activator