Carotid Artery Stenting Following Transcatheter Aortic Valve Implantation for Severe Aortic Stenosis: A Case Report.

Abstract

Objective: During the perioperative period of carotid artery stenting (CAS), severe aortic stenosis (AS) is associated with a risk of serious complications, such as cardiac arrest. There is no consensus regarding the order of treatment for patients with severe AS concomitant with proximal carotid artery stenosis. We herein report a case in which CAS following transcatheter aortic valve implantation for severe AS was safely performed in an older high-risk patient.

Case presentation: An 84-year-old woman presented with severe aortic stenosis that required treatment. Magnetic resonance angiography revealed severe left proximal internal carotid stenosis. Cerebral blood flow measurements revealed a normal cerebral perfusion. An uneventful transcatheter aortic valve implantation for severe aortic stenosis was followed by carotid stenting at a 2-month interval.

Conclusion: Staged treatment may be a safe and effective strategy in high-risk patients with concomitant severe AS and carotid stenosis. In cases with a normal cerebral blood flow, CAS following transcatheter aortic valve implantation can be a reasonable option, especially in older patients with multiple comorbidities.