Stenting with Coil Embolization for Dissecting Restenosis of the Internal Carotid Artery after Balloon Angioplasty

概要

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We report here the successful use of endovascular stenting combined with coil embolization for dissective restenosis of the internal carotid artery after balloon angioplasty. The patient was a 76-year-old man was with a history of frequent transient right hemiparesis. Angiogram showed severe stenosis in the cervical portion of both internal carotid arteries. The left lesion was treated initially by percutaneous transluminal angioplasty, which resulted in satisfactory dilatation. However, three months later, angiogram revealed restenosis and subintimal dissection at the original region. Stent implantation was performed to reconstruct the true arterial lumen, then packed the false lumen with Guglielmi detachable coils through the stent mesh. Despite anticoagulation therapy, right leg monoparesis developed two days after coiling but disappeared after a week. Nine months later, complete obliteration of the false lumen and patency of the internal carotid artery were confirmed on angiogram. This combined technique may be useful to better manage dissecting restenosis in the cervical portion of the left internal carotid artery after balloon angioplasty.
長崎大学の論文