A Case of Urgent Carotid Artery Stenting for Repeated Transient Ischemic Attack Caused by Complete Atrioventricular Block after Transcatheter Aortic Valve Replacement

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  • HORIUCHI Kazufumi
    Department of Neurosurgery, Kobe City Medical Center General Hospital
  • IMAMURA Hirotoshi
    Department of Neurosurgery, Kobe City Medical Center General Hospital
  • SUZUKI Keita
    Department of Neurosurgery, Kobe City Medical Center General Hospital
  • EHARA Natsuhiko
    Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital
  • AZUMI Yuta
    Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital
  • KIM Kite
    Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital
  • FURUKAWA Yutaka
    Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital
  • SAKAI Nobuyuki
    Department of Neurosurgery, Kobe City Medical Center General Hospital

Bibliographic Information

Other Title
  • 経カテーテル的大動脈弁置換術施行後に生じた完全房室ブロックにより一過性脳虚血発作を繰り返したため，緊急で頚動脈ステント留置術を施行した1 例
  • 症例報告 経カテーテル的大動脈弁置換術施行後に生じた完全房室ブロックにより一過性脳虚血発作を繰り返したため,緊急で頚動脈ステント留置術を施行した1例
  • ショウレイ ホウコク ケイ カテーテルテキ ダイドウミャクベン チカンジュツ シコウ ゴ ニ ショウジタ カンゼン ボウシツブロック ニ ヨリ イッカセイ ノウキョケツ ホッサ オ クリカエシタ タメ,キンキュウ デ ケイドウミャク ステント リュウチジュツ オ シコウ シタ 1レイ

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Abstract

<p>Objective: A patient with symptomatic carotid artery stenosis (SCAS), complicated with symptomatic severe aortic stenosis (SSAS) had frequent transient ischemic attacks (TIAs) caused by complete atrioventricular block (AV block) after transcatheter aortic valve replacement (TAVR). After TAVR, the patient required urgent carotid artery stenting (CAS) as a result of the hemodynamic changes induced by an AV block and the analysis of the morphological and functional events after treatment in such cases is presented.</p><p>Case Presentation: An elderly patient with combined SCAS and SSAS was scheduled by endovascular intervention. Initially, TAVR was performed, however an AV block developed, followed by frequent TIAs. CAS and permanent pacemaker placement were performed to prevent further TIAs or stroke. After the CAS was required management for cerebral hyperperfusion syndrome (CHS), but risks of fatal asystole or acute heart failure with bradycardia and hypotension while expanding the stenotic carotid lesion was avoided.</p><p>Conclusion: Regarding the case of SCAS complicated with SSAS, TAVR to precede CAS could become one of the treatment options.</p>

Journal

  • No Kekkannai Chiryo

    No Kekkannai Chiryo 5 (2), 93-99, 2020

    The Japanese Society for Neuroendovascular Therapy

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