Probable Delayed Plaque Protrusion After Carotid Artery Stenting With a Dual-Layer Micromesh Stent.

Abstract

<h4>Background</h4>We report a case of a late filling defect more than 2 weeks after stenting with dual-layer micromesh stent.<h4>Case summary</h4>An 83-year-old woman presented with right hemiparesis and mixed aphasia. Cerebral angiography showed left internal carotid artery bifurcation severe stenosis. We performed carotid artery stenting (CAS) using a dual-layer micromesh stent. Carotid ultrasound performed within 1 week after CAS showed no plaque protrusion (PP); however, ultrasound performed on postoperative day 17 showed a filling defect. A closed stent was placed using a stent-in-stent technique. We submitted debris found in the filter suspected to be plaque for pathologic examination. She transferred with modified Rankin Scale 4, 2 months later from second CAS.<h4>Discussion</h4>This is the first report to our knowledge to suggest by pathologic examination that a late filling defect may be delayed PP after stenting with a CASPER stent.<h4>Take-home message</h4>This case report indicated that PP may occur more than 2 weeks after CAS.