case_images: PMC11835061_01
case_images: Comparison of patients with carotid artery stenting before and after implantation. (A) The last left general carotid artery stenosis in the DSA. The yellow arrow is the stent shadow of the last general carotid artery stent implantation. (B and C) Unobstructed stent insertion lumen in the DSA. DSA = digital subtraction angiography.
case_images: medi-104-e41473-g001.jpg
case_images: PMC11835061_01_medi-104-e41473-g001.jpg
case_images: F1
case_images: Next, the digital subtraction angiography (DSA) examination suggested severe stenosis of the terminal left common carotid artery and the beginning of the internal carotid artery with a stenosis of  80% (Fig. 1A). Hence, we then implanted a 9 x 40 mm2 WALLSTENT self-expanding stent at the left carotid artery stenosis site (Fig. 1B and C).
case_images: CT scan of the brain immediately after stenting when the patient developed symptoms. (A-I) Multiple high-density strips were observed in the left cerebral hemisphere, part of the right frontal sulcus, cerebral falx, and cerebellar curtain. Edema of brain tissue was also observed. CT = computed tomography.
case_images: medi-104-e41473-g002.jpg
case_images: PMC11835061_01_medi-104-e41473-g002.jpg
case_images: F2
case_images: The emergency cranial computed tomography (CT) re-examination suggested edema in the large area of left cerebral hemisphere; swelling and blurring of gyri; shallowing of sulci; and cerebral fissures compared with the contralateral side; midline was in the center; and left cerebral hemisphere, some sulci in the right frontal lobe, falx cerebri, and tentorium cerebelli had multiple striped hyperdensities (Fig. 2A-I).
case_images: Follow-up cranial MRI after CAS. (A) Magnetic resonance DWI imaging after CAS, DWI point-like high signal in the left parietal lobe, with possible acute/subacute cerebral infarction. (B) Magnetic resonance ADC imaging after CAS. ADC = apparent diffusion coefficient, CAS = carotid artery stenting, DWI = diffusion-weighted imaging.
case_images: medi-104-e41473-g003.jpg
case_images: PMC11835061_01_medi-104-e41473-g003.jpg
case_images: F3
case_images: On the first postoperative day, magnetic resonance imaging was performed on the patient and the results showed a punctate diffusion-weighted imaging high signal in the left parietal lobe (Fig. 3A and B).