Internal Carotid Artery Stenting

Carotid artery stenting in a case with bilateral carotid artery stenoses.
54 yr old gentleman, a known hypertensive – on treatment with H/O cerebrovascular event in 2012 presented with speech disturbance since 1 week. CT angiogram shows bilateral carotid artery stenoses.

Evaluation of intracranial circulation revealed an incomplete Circle of Willis with isolated left MCA and a fetal left PCA.

Baseline angiogram during procedure confirmed bilateral internal carotid artery stenoses.

Due to severe left ICA stenosis, isolation of left MCA, prior infarct in left MCA territory and current presentation of left MCA event, left ICA stenting was performed with distal embolic protection.