Retinal artery embolization during carotid angioplasty and carotid artery stenting: case report

Neurol Med Chir (Tokyo). 2009 May;49(5):213-6. doi: 10.2176/nmc.49.213.

Abstract

A 69-year-old man presented with a rare case of retinal artery embolization, which occurred as a complication of carotid angioplasty and carotid artery stenting performed for recurrent cerebral infarction. Magnetic resonance imaging and angiography showed right internal carotid artery stenosis with ulceration. Carotid angioplasty and carotid artery stenting were performed using the distal protection system with the PercuSurge GuardWire. However, just after dilation, the patient complained of ocular pain and blurred vision on the right, which was subsequently diagnosed as retinal artery embolization. Heparin was given for 15 hours after stenting, and aspirin and ticlopidine medication were continued. The patient received hyperbaric oxygen therapy for 1 week. The patient's blurred vision gradually improved, but visual field defect remained. Debris was probably flushed into the external carotid artery, and passed through an anastomosis into the ophthalmic artery, resulting in retinal artery embolization.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Angioplasty, Balloon / adverse effects*
  • Anticoagulants / administration & dosage
  • Anticoagulants / therapeutic use
  • Antipyrine / administration & dosage
  • Antipyrine / analogs & derivatives
  • Antipyrine / therapeutic use
  • Aspirin / administration & dosage
  • Aspirin / therapeutic use
  • Carotid Artery, External
  • Carotid Stenosis / complications
  • Carotid Stenosis / therapy*
  • Cerebral Infarction / etiology
  • Combined Modality Therapy
  • Drug Therapy, Combination
  • Edaravone
  • Embolism / drug therapy
  • Embolism / etiology*
  • Heparin / administration & dosage
  • Heparin / therapeutic use
  • Humans
  • Hyperbaric Oxygenation
  • Intraoperative Complications / etiology*
  • Male
  • Methacrylates / administration & dosage
  • Methacrylates / therapeutic use
  • Ophthalmic Artery
  • Recurrence
  • Retinal Artery Occlusion / drug therapy
  • Retinal Artery Occlusion / etiology*
  • Stents*
  • Ticlopidine / administration & dosage
  • Ticlopidine / therapeutic use

Substances

  • Anticoagulants
  • Methacrylates
  • Heparin
  • ozagrel
  • Ticlopidine
  • Aspirin
  • Edaravone
  • Antipyrine