Back to Search
Start Over
Carotid artery stenosis concomitant with severe aortic stenosis treated by combination of staged angioplasty and transcatheter aortic valve implantation: A case report
- Source :
- Surgical Neurology International. 13:469
- Publication Year :
- 2022
- Publisher :
- Scientific Scholar, 2022.
-
Abstract
- Background: When severe aortic stenosis (AS) is concomitant with carotid stenosis, carotid artery stenting (CAS) will become a high-risk procedure because baroreceptor reflex-induced bradycardia and hypotension may cause irreversible circulatory collapse. When carotid stenosis-related misery perfusion is present, the risk of cerebral hyperperfusion syndrome increases after carotid revascularization. We report a case of severe carotid disease concomitant with severe AS successfully treated by a combination of staged angioplasty (SAP) and transcatheter aortic valve implantation (TAVI). Case Description: An 86-year-old man presented with transient deterioration of mental status and sluggish responsiveness continuous from the previous day. Magnetic resonance imaging of the brain revealed a right putaminal infarction, occlusion of the right internal carotid artery (ICA), and severe stenosis of the left ICA. Severe AS was diagnosed and single-photon emission computed tomography showed misery perfusion at the bilateral ICA territories. We performed a staged treatment consisting of SAP for the left carotid stenosis and TAVI. A first-stage carotid angioplasty was performed, followed by TAVI 2 weeks later and second-stage CAS 1 week after that. There were no apparent periprocedural complications throughout the clinical course. Conclusion: Combining SAP and TAVI may be an effective treatment option for severe carotid stenosis with misery perfusion concomitant with severe AS.
- Subjects :
- Surgery
Neurology (clinical)
Subjects
Details
- ISSN :
- 21527806
- Volume :
- 13
- Database :
- OpenAIRE
- Journal :
- Surgical Neurology International
- Accession number :
- edsair.doi...........f0e9e77d2c4d13af64a273a1bb39615d