The case of treatment for carotid web – Double-layer micromesh stent implantation in our hospital

Author:

Kamatani Kaisei1,Yoshida Shinichiro1,Tashiro Noriaki2,Hashiguchi Yoshiya2,Takigawa Kousuke1,Yasaka Masahiro2,Aikawa Hiroshi1,Go Yoshinori1,Kazekawa Kiyoshi1

Affiliation:

1. Department of Neurosurgery, Fukuoka Neurosurgical Hospital, Fukuoka, Japan.

2. Department of Cerebrovascular Medicine, Fukuoka Neurosurgical Hospital, Fukuoka, Japan.

Abstract

Background: A carotid web is a shelf-like structure on the posterior wall of the origin of the internal carotid artery, and it is believed to cause cerebral infarction due to thrombus formed by turbulent flow with stagnation of blood flow. Recently, it has been suggested that recurrent cerebral infarction cannot be prevented in patients with a symptomatic carotid web by conventional medical management alone. However, there is still no consensus on the treatment of carotid webs. Carotid artery stenting (CAS) with the CASPER stent (Microvention, Terumo, Tustin, CA, USA) was performed in six consecutive patients with symptomatic carotid webs, and the results are reported along with a review of the literature. Methods: Six consecutive patients with a diagnosis of internal carotid artery stenosis due to a carotid web on magnetic resonance imaging and digital subtraction angiography (DSA) were included in this study. All patients underwent dual antiplatelet therapy approximately 10 days before surgery and after 6 months, and then, a CASPER stent was implanted under general anesthesia. All patients were evaluated postoperatively by DSA 6 months after treatment. Results: In all patients, no in-stent stenosis was seen 6 months after the operation, and no symptomatic cerebral infarction occurred within 1 year after the procedure. Conclusions: CASPER stent implantation may be effective for treating carotid webs.

Publisher

Scientific Scholar

Subject

Neurology (clinical),Surgery

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