[A case of carotid occlusive disease treated with stenting for recurrence of stenosis: strategy on intolerance to temporary occlusion].

Carotid artery stenting has emerged as an acceptable treatment alternative in patient with occlusive carotid bifurcation disease. High-risk surgical candidates have a lower rate of morbidity after carotid artery stenting with distal embolic protection. Among distal protection devices, a Guardwire balloon occlusion is the most frequently employed in Japan. A 79-year-old male who had severe stenosis at the origin of left carotid artery was treated with stenting under Guardwire balloon protection. He was intolerant to carotid artery occlusion and endovascular procedures were performed under intravenous anesthesia or general anesthesia. In addition, he suffered recurrent stenosis seven months after the first procedure and 16 months after second procedure, and underwent repeated intervention. It was considered that the long tortuous lesion was a cause of the recurrent stenosis.