Duplex ultrasound assisted endovascular revascularization of chronic internal carotid artery occlusion: technical note

Carotid artery occlusion is a major risk factor for ischemic stroke. Endovascular treatment of carotid artery occlusion in high-risk patients offers a therapeutic option to reduce subsequent ischemic events. The technical success and avoidance of complications of the endovascular recanalization of occluded carotid artery is contingent on proper visualization of the vessel wall. To highlight the value of duplex ultrasound guidance, we herein described the procedural details of the use of ultrasound guidance for characterization and visualization of the endovascular devices as well as the vessel wall during endovascular revascularization. Patient was a 54-year-old woman, diagnosed with carotid occlusion with recurrent symptomatic episodes. Endovascular revascularization was successfully performed by ultrasound assistance upon traversing the occluded segment and accurate deployment of stent. The patient was followed for 3 months and has not experienced any ischemic symptoms. Duplex ultrasound guidance helps preventing the vessel wall injury and dissection during revascularization of chronically occluded carotid artery. Ultrasound guidance may improve the outcomes of the endovascular procedures in high-risk patients with carotid occlusion.