Stenting for intracranial internal carotid artery stenosis with the use of a coronary stent: a case report

A 61-year-old man was admitted to our hospital for mild left hemiparesis and speech disturbance. An initial angiogram revealed occlusion of the right internal carotid artery (ICA) but with sufficient collateral flow by compensated the contralateral carotid artery. Severe stenosis (70%) in the intracavernous (C4-5) portion was identified in the left ICA. Cerebral blood flow was remarkably decreased in both hemispheres. The patient's hemiparesis fluctuated according to the systemic blood pressure in such a manner that induced hypertension therapy was mandatory. On the 19th hospital day, we performed stenting of the left ICA stenosis using a coronary stent. A flexible coronary stent, NIR PRIMO(R) stent 3.0mm/16mm (SCIMED, Boston Scientific) was deployed after the predilatation (2.5mm/10atm). The initial 70% stenosis was reduced to 6% after the postdilatation (3.75mm/8atm). The neurological status was stable after the procedure and we stopped the induced hypertension therapy the next day. We consider that intracranial artery stenting will be a common therapeutic modality in the near future.