A 77-year-old man with an asymptomatic 80% stenosis of the right internal carotid artery (ICA) underwent successful carotid artery stenting (CAS) with the Carotid WALLSTENT™, 7.0×30 mm (Boston Scientific, Marlborough, MA, USA) under distal embolic protection in February 2011 (Panel A, Panel B). Five months later he presented with a three-week history of intermittent dizziness and vision impairment. Cerebral magnetic resonance imaging (MRI) showed no signs of cerebral ischaemia. Angio MRI revealed a high grade restenosis of the right ICA. This finding was confirmed during angiography. It showed a 95% restenosis of the ICA in the same segment, just above the bifurcation, which was stenosed prior to stent implantation (Panel C). The stent was located proximally to the restenosis and appeared shorter in size now. Measurements showed a shrinkage of approximately 30% (Panel D, Panel E). A re-stenting using a Precise®, 7×30 mm (Cordis, Johnson & Johnson, Warren, NJ, USA) of the ICA under distal embolic protection was successfully performed (Panel F). A follow-up angio MRI two years later revealed no restenosis.
Delayed Carotid WALLSTENT shortening and restenosis can occur even after successful CAS. Therefore, regular short-term follow-up evaluation is important to detect unexpected complications such as stent shortening.
Conflict of interest statement
The authors have no conflicts of interest to declare.
