Symptomatic carotid vasospasm caused by a distal-protection device during stent angioplasty of the right internal carotid artery

Tex Heart Inst J. 2010;37(2):226-9.

Abstract

Percutaneous carotid stenting with a distal-protection device is now considered an alternative to standard carotid endarterectomy. Although distal-protection filter devices have been reported to reduce the risk of embolism and stroke, their use is associated with such iatrogenic complications as vasospasm, dissection, and guidewire entrapment. Herein, we report a case of symptomatic carotid vasospasm caused by a distal-protection filter device during right internal carotid artery intervention in a woman who had underlying coronary artery disease. We also discuss the management of iatrogenic carotid spasm.

Keywords: Angioplasty/adverse effects; carotid artery diseases; carotid stenosis; embolism/prevention & control; filtration/methods; hypotension; iatrogenic disease; stents; stroke/etiology/prevention & control; vasospasm, intracranial.

Publication types

  • Case Reports

MeSH terms

  • Angioplasty, Balloon / adverse effects
  • Angioplasty, Balloon / instrumentation*
  • Cardiac Pacing, Artificial
  • Carotid Artery, Internal* / diagnostic imaging
  • Carotid Stenosis / complications
  • Carotid Stenosis / diagnostic imaging
  • Carotid Stenosis / therapy*
  • Coronary Artery Disease / complications
  • Device Removal
  • Female
  • Filtration / instrumentation*
  • Humans
  • Iatrogenic Disease*
  • Middle Aged
  • Radiography
  • Spasm / diagnostic imaging
  • Spasm / etiology*
  • Spasm / therapy
  • Stents*
  • Stroke / etiology
  • Stroke / prevention & control
  • Treatment Outcome
  • Vasodilator Agents / therapeutic use

Substances

  • Vasodilator Agents