Intracranial internal carotid artery angioplasthy and stenting in giant cell arteritis.
We report the case of a 59-year-old woman who presented with several episodes of transient ischemic attack (TIA) caused by pathologically confirmed giant cell arteritis. She continued suffering from TIAs during admission despite immunosuppressant and antithrombotic therapy. Sudden neurological deterioration with paraparesis and cognitive impairment developed. A brain magnetic resonance (MR) imaging showed bilateral watershed ischemic lesions. MR angiography demonstrated severe stenosis of both intracranial internal carotid arteries (ICAs). Angioplasty and stenting on the left ICA were performed, with evident clinical improvement occurring within 24 hours. Endovascular therapy may be an alternative option to treat severe GCA with symptomatic intracranial large vessel disease not responsive to intensive conventional medical treatment.
Stroke Unit, Department of Neurology, Hospital Universitario 12 de Octubre, Madrid, Spain.
Antonio Méndez
AM
Guerrero
Stroke Unit, Department of Neurology, Hospital Universitario 12 de Octubre, Madrid, Spain.|Instituto de Investigación Hospital 12 de Octubre (i+12), Madrid, Spain.
Fernando
F
Sierra-Hidalgo
Stroke Unit, Department of Neurology, Hospital Universitario 12 de Octubre, Madrid, Spain.
Patricia
P
Calleja
Interventional Neuroradiology Unit, Hospital Universitario 12 de Octubre, Madrid, Spain.
Pedro
P
Navia
Interventional Neuroradiology Unit, Hospital Universitario 12 de Octubre, Madrid, Spain.
Jorge
J
Campollo
Stroke Unit, Department of Neurology, Hospital Universitario 12 de Octubre, Madrid, Spain.
Jaime
J
Díaz-Guzmán
D017130:Angioplasty / Q000295:instrumentation* / Q000379:methods*; D001807:Blood Vessel Prosthesis; D002343:Carotid Artery, Internal / Q000601:surgery*; D016893:Carotid Stenosis / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D003131:Combined Modality Therapy / Q000295:instrumentation / Q000379:methods; D005260:Female; D013700:Giant Cell Arteritis / Q000150:complications / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D015607:Stents; D016896:Treatment Outcome
Giant cell arteritis; endovascular therapy; intracranial stenosis; stroke