PMC7357021_01
Diffusion-weighted magnetic resonance imaging showing acute ischemic stroke lesions (red arrows) in the right hemisphere.
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Cerebral magnetic resonance imaging (MRI) and angiography (MRA) (Figure 1) demonstrated several small acute ischemic lesions in the territory of the right middle cerebral artery (MCA) with no visible vessel occlusion (Figure 1).
Neuroimagings presenting a carotid web (red arrows) in the right proximal internal carotid artery: (a) MR angiography, (b) CT angiography, (c) neurovascular sonography, and (d) digital subtraction angiography.
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Also, MRA (Figure 2(a)) identified an intraluminal contrast filling defect in the proximal part of the right internal carotid artery (ICA), suspected to be a carotid web. Computer tomography angiography (CTA) (Figure 2(b)) and color-coded duplex sonography (Figure 2(c)) confirmed the suspected diagnosis of a carotid web in the right ICA. Taking the considerable rate of recurrent cerebrovascular ischemic events in patients with a symptomatic carotid web treated conservatively reported in literature and our hospital's neurointerventionalists' expertise into account, a digital subtraction angiography (DSA) (Figure 2(d)) was performed and a CGuard stent (7 mm x 30 mm) (Figure 3(a)) was deployed in the right extracranial carotid artery.
Neuroimagings after carotid artery stenting: (a) digital subtraction angiography and (b) neurovascular sonography.
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Taking the considerable rate of recurrent cerebrovascular ischemic events in patients with a symptomatic carotid web treated conservatively reported in literature and our hospital's neurointerventionalists' expertise into account, a digital subtraction angiography (DSA) (Figure 2(d)) was performed and a CGuard stent (7 mm x 30 mm) (Figure 3(a)) was deployed in the right extracranial carotid artery. On the following day, color-coded duplex sonography (Figure 3(b)) showed a fully open stent without any flow or structural abnormalities.