A case of de novo extra-stent ulceration induced by persistent plaque protrusion after carotid artery stenting with a CASPER stent for a large-volume unstable plaque

Autor: Ryo Aiura, MD, Yoshikazu Matsuda, PhD, Tomoya Matsumoto, MD, Shun Takano, MD, Minako Kubo, PhD, Ryo Irie, MD, Eisuke Hirose, MD, Takato Nakajyo, PhD, Tatsuya Sugiyama, PhD, Tohru Mizutani, PhD
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Radiology Case Reports, Vol 19, Iss 12, Pp 6187-6192 (2024)
Druh dokumentu: article
ISSN: 1930-0433
DOI: 10.1016/j.radcr.2024.09.061
Popis: Plaque protrusion (PP) has been identified as a perioperative complication of carotid artery stenosis treated with carotid artery stenting (CAS). The CASPER stent (CS), a dual-layer micromesh stent, may be able to prevent PP. Despite using CS, de novo extra-stent ulceration induced by persistent PP is rare.A 75-year-old male patient, whose superficial temporal artery-middle cerebral artery bypass tended to occlude, underwent CAS using a CS for symptomatic pseudo-occlusive internal carotid artery with a large-volume unstable plaque. This led to de novo extra-stent ulceration induced by persistent PP, resulting in ischemic stroke that necessitated the application of the stent-in-stent technique. There was no recurrence of cerebral infarction postoperatively at 12 months.Here, we present, to the best of our knowledge, the first case of a patient with de novo extra-stent ulceration induced by persistent PP after CAS that led to de novo extra-stent ulceration. The inhibition of intimal formation on the stent surface caused by persistent PP was considered to be the underlying mechanism. The stent-in-stent technique is beneficial even in cases of PP accompanied by de novo extra-stent ulceration.
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