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AJNR - American Journal of Neuroradiology

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Spontaneous Improvement of Peristent Ulceration after Carotid Artery Stenting

S. Kohyama^a, K. Kazekawa^a, M. Iko^a, H. Aikawa^a, M. Tsutsumi^a, Y. Go^a, S. Nagata^a, T. Kodama^a, K. Nii^a, S. Matsubara^a and A. Tanaka^a

^a Department of Neurosurgery, Fukuoka University Chikushi Hospital, Chikushino, Japan

View larger version (101K): [in a new window]   Fig 1. Patient 30, a 76-year-old man with left hemispheric TIAs. Left carotid angiogram (anteroposterior view) showing moderate stenosis with plaque ulceration (left). Small peristent ulceration (arrow) just after CAS (center) disappeared with expansion of a stent in 4 months (right). This is the smallest peristent ulceration in our series.

View larger version (116K): [in a new window]   Fig 2. Patient 26, a 77-year-old woman with multiple infarction in the right cerebral hemisphere. Right carotid angiogram (lateral view) revealing mild stenosis with irregular carotid wall, which is considered as a plaque ulceration (left). Diffuse shallow peristent ulceration in the internal carotid artery (arrows) just after CAS (center) improved after 4 months (right).

View larger version (105K): [in a new window]   Fig 3. Patient 21, a 70-year-old man with bilateral hemispheric TIAs. Right carotid angiogram (lateral view) showing mild stenosis with plaque ulceration (left). Large peristent ulceration just after CAS (center) disappeared after 1 month (right). (Left carotid stenosis was also treated with CAS.)

View larger version (103K): [in a new window]   Fig 4. Patient 25, an 81-year-old man with crescendo TIAs. Right carotid angiogram (lateral view) revealing mild-to-moderate stenosis with large plaque ulceration (left). Large peristent ulceration just after CAS (center) disappeared after 4 months (right).

View larger version (81K): [in a new window]   Fig 5. Patient 19, a 60-year-old man with a recent history of left cerebral infarction. Left, Left carotid artery angiogram (anteroposterior view) revealing severe stenosis with irregular plaque surface. Center, Angiogram just after CAS showing residual stenosis and diffuse peristent ulceration because of high-grade calcification of the plaque. Right, Peristent ulceration improved after 5 months.