Fig. 1: Left carotid arteriogram demonstrating >90% re-stenosis at the origin of the left ICA (white arrow).
Fig. 2: Spot image obtained just after stent release demonstrating satisfactory position with the stenosis visible in the proximal to mid portion of the stent.
Fig. 3, 4: Left carotid arteriogram following balloon dilatation to 5 mm distally and 6 mm at the proximal portion of the stent. The stent is in good position, wall apposition is excellent, and there is no evidence of residual stenosis or dissection. Flow into the external carotid artery is unimpeded.
Fig. 5: Schematic illustration of the protected angioplasty procedure (after Theron). A, the guiding catheter is positioned close to the stenosis of the internal carotid artery near the bifurcation. B, the angioplasty and occlusive catheters are positioned across the internal carotid artery stenosis. C, the latex occlusion balloon is inflated. D, the angioplasty balloon is inflated during flow arrest. E, the occlusive balloon remains inflated during deflation and removal of the angioplasty balloon. Atherosclerotic and thrombotic debris are aspirated through the side-port of the guiding catheter with potential residual fragments flushed into the external carotid artery.
