Dakhoul Lara Toufic, Tawk Rabih
Advocate Christ Medical Center, Oak Lawn, IL, USA.
Mayo Clinic Hospital, Jacksonville, FL, USA.
J Investig Med High Impact Case Rep. 2014 Sep 2;2(3):2324709614548796. doi: 10.1177/2324709614548796. eCollection 2014 Jul-Sep.
Objectives. To highlight the case of a patient with multiple transient ischemic attacks and visual disturbances diagnosed with carotid stump syndrome and managed with endovascular approach. Case Presentation. We present the case of a carotid stump syndrome in an elderly patient found to have moderate left internal carotid artery stenosis in response to an advertisement for carotid screening. After a medical therapeutic approach and a close follow-up, transient ischemic attacks recurred. Computed tomographic angiography showed an occlusion of the left internal carotid artery and the presence of moderate stenosis in the right internal carotid artery, which was treated by endovascular stenting and balloon insertion. One month later, the patient presented with visual disturbances due to the left carotid stump and severe stenosis of the left external carotid artery that was reapproached by endovascular stenting. Conclusion. Considerations should be given to the carotid stump syndrome as a source of emboli for ischemic strokes, and vascular assessment could be used to detect and treat this syndrome.
目的。强调一例患有多次短暂性脑缺血发作和视觉障碍的患者，诊断为颈动脉残端综合征并采用血管内治疗方法进行处理。病例介绍。我们报告一例老年患者的颈动脉残端综合征病例，该患者因颈动脉筛查广告而被发现左颈内动脉中度狭窄。经过药物治疗和密切随访后，短暂性脑缺血发作复发。计算机断层血管造影显示左颈内动脉闭塞，右颈内动脉存在中度狭窄，通过血管内支架置入和球囊扩张进行治疗。一个月后，患者因左颈动脉残端出现视觉障碍，且左颈外动脉严重狭窄，再次采用血管内支架置入术进行治疗。结论。应将颈动脉残端综合征视为缺血性卒中的栓子来源，并可通过血管评估来检测和治疗该综合征。
