T-Configuration Stent Placement for Carotid Bifurcation Stenosis Co-Existing with Ipsilateral Intracranial Stenosis: A Case Report and Literature Review

Abstract

In patients with carotid bifurcation stenosis co-existing with ipsilateral intracranial artery stenosis, combined treatment with carotid artery stenting (CAS)/carotid endarterectomy (CEA) and extracranial-to- intracranial (EC-IC) bypass can be a useful option to prevent future ischemic stroke events. EC-IC bypass requires a sufficient antegrade flow in the ipsilateral external carotid artery. However, standard CAS/CEA occasionally lead to external carotid artery occlusion. Herein, we present a case of successful one-stage endovascular revascularization of both the antegrade internal and external carotid artery flow using the carotid T-stent technique for carotid bifurcation stenosis co-existing with ipsilateral middle cerebral artery stenosis.

Keywords: Carotid artery stenting; Carotid endarterectomy; Common carotid artery stenosis; External carotid artery stenosis; Extracranial-to-intracranial anastomosis; Extracranial-to-intracranial bypass; Internal carotid artery stenosis; Middle cerebral artery stenosis.