case_images: PMC6024505_01
case_images: PMC6024505_02
case_images: Cervical angiogram initial diagnostic views prior to stent placement. (a) Anterior to posterior projection (b) and lateral projection
case_images: SNI-9-123-g001.jpg
case_images: PMC6024505_02_SNI-9-123-g001.jpg
case_images: F1
case_images: Initial anteroposterior and lateral common carotid artery (CCA) injections demonstrated severe stenosis of 3 mm in diameter occurring just distal to the bifurcation of the common carotid artery [Figure 1].
case_images: Cervical angiogram in oblique working projection of carotid artery bifurcation demonstrating adequate luminal diameter following stent deployment
case_images: SNI-9-123-g002.jpg
case_images: PMC6024505_02_SNI-9-123-g002.jpg
case_images: F2
case_images: A post stent deployment angiogram was performed in the working projections which demonstrated significant improvement in the vessel lumen with good stent wall apposition [Figure 2].
case_images: PMC6024505_03
case_images: Three-dimensional volume of interest DYNA CT highlighting the torsional configuration of the stent in an axial plane
case_images: SNI-9-123-g003.jpg
case_images: PMC6024505_03_SNI-9-123-g003.jpg
case_images: F3
case_images: At this point, we felt two-dimensional (2D) angiography was not adequate in diagnosis, and therefore, a volume of interest Dyna CT with 3D reconstructions were obtained. 3D reconstructions demonstrated persistent stenosis within the mid portion of the stent and reticent calcified plaque [Figure 3].
case_images: Intraoperative extraction of the retained distal protection device and carotid artery stent device. Morphology and severity of atherosclerotic stenosis is easily visualized
case_images: SNI-9-123-g004.jpg
case_images: PMC6024505_03_SNI-9-123-g004.jpg
case_images: F4
case_images: Upon opening the common carotid artery, the wire was cut proximally and removed from the femoral sheath [Figure 4].
case_images: Postoperative diagnostic angiogram in oblique working projection demonstrating improved stenosis without evidence of dissection or flow limiting stenosis
case_images: SNI-9-123-g005.jpg
case_images: PMC6024505_03_SNI-9-123-g005.jpg
case_images: F5
case_images: Postoperative angiogram demonstrated appropriate flow through the carotid artery without evidence of residual stenosis or distal thrombotic complication [Figure 5].
case_images: PMC6024505_04