2024-03-29T15:40:18Z
https://nagoya.repo.nii.ac.jp/oai
oai:nagoya.repo.nii.ac.jp:00024905
2023-11-16T04:18:05Z
499:508:509:2043
Crevice sign as an indicator of plaque laceration associated with postoperative severe thromboembolism after carotid artery stenting : a case report
Ohshima, Tomotaka
Yamamoto, Taiki
Goto, Shunsaku
Ishikawa, Kojiro
Nishizawa, Toshihisa
Shimato, Shinji
open access
Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International
carotid artery stenosis
carotid artery stenting
complication
plaque
thromboembolism
Carotid artery stenting (CAS) is increasingly utilized in patients with carotid artery stenosis. Various intraprocedural and postprocedural complications have been reported in the literature. We present a case of symptomatic major thromboembolism after CAS. The intraprocedural angiogram showed extraordinary slow filling of the contrast medium into the plaque, which we named as “crevice sign.” An 83-year-old man presented repeat right amaurosis fugax for 6 months. The radiological examinations revealed 85% stenosis of the origin of the right internal carotid artery. The patient underwent right CAS. The procedure was performed without any problems; however, the angiogram showed slow filling of contrast medium into the carotid plaque through the stent (crevice sign). Sixty minutes later in the ward, the patient presented sudden onset of left hemiparesis and aphasia. Emergency catheter angiography did not show in-stent thrombus, major artery occlusion, or the crevice sign. Magnetic resonance imaging on the next day revealed wide acute infarction of the right cerebral hemisphere. Physicians should be aware of the intraprocedural crevice sign so that a subsequent catastrophic ischemic event can be prevented.
Nagoya University Graduate School of Medicine, School of Medicine
2017-11
eng
departmental bulletin paper
VoR
https://doi.org/10.18999/nagjms.79.4.559
http://hdl.handle.net/2237/27125
https://nagoya.repo.nii.ac.jp/records/24905
10.18999/nagjms.79.4.559
http://www.med.nagoya-u.ac.jp/medlib/nagoya_j_med_sci/794.html
2186-3326
0027-7622
Nagoya Journal of Medical Science
79
4
559
564
https://nagoya.repo.nii.ac.jp/record/24905/files/15_Ohshima.pdf
application/pdf
3.0 MB
2018-02-22