Recanalization of a chronic A. Carotis communis occlusion
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Tyrimo grupės vadovas / Research group head |
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2020-03-27 |
ISBN 978-9934-8927-1-4.
Introduction. Stenosis or occlusion of the common carotid artery is dangerous and could cause symptoms of acute ischemic stroke. Recanalization of a chronic a.carotis communis occlusion is rare because the procedure is difficult and dangerous. Nevertheless, it is possible with good results. Case description. In 2017 January a 67-year-old male patient was hospitalized because he complained of acute ischemic stroke symptoms: speech disfunction, left arm and left leg severe paresis. Thrombolysis was not administered because these symptoms had started several days before. Symptoms began to decrease after the patient’s condition stabilized at the hospital. Angiography revealed: right common carotid artery from its origin was occluded, no anterior or posterior communicates where found. Right vertebral artery had 90% stenosis and supplied blood to both internal and external carotid arteries. The vertebral artery was recanalized with balloon catheter and stent. After the procedure symptoms began to regress, only minor paresis and speech disorder remained. The right common carotid artery was left occluded considering it was an old occlusion. 2019 June paresis and speech disorder increased. Angiography showed the recanalized vertebral artery was not stenosed. Multidisciplinary consilium conclusion: recanalization was the only option with surgery being high risk. The procedure was successful with placing two stents (7-40mm; 9-40mm) in right common carotid artery. After the treatment symptoms began to decrease again. Conclusions. When patient condition is deteriorating selective recanalization of chronic occlusion may be attempted to restore perfusion. The procedure is difficult and very dangerous, but when executed properly - successful. Summary. We present a case report of a 67-year-old patient which presented ischemic stroke symptoms and had a chronic occluded right common carotid artery. Internal carotid artery was supplied by the vertebral artery. Because [...].