Objective: In the present report, we describe a case of progressive cerebral infarction wherein stent implantation was performed for a stenotic lesion at the origin of the persistent primitive proatlantal artery (PPPA), and resulted in internal carotid artery (ICA) stenosis due to postoperative plaque shift. Case presentation: A 71-year-old man visited our hospital with an episode of transient left hemiplegia. During medical therapy, a progressive cerebral infarction was observed. Digital subtraction angiography revealed stenosis in the PPPA, suggesting a pathological basis for the arteriogenic embolism. A stent was implanted, and the stenotic lesion was well dilated. Subsequently, the plaque shifted to the ICA. Conclusion: Although plaque shift is a rare phenomenon in neuroendovascular therapy, preoperative assessment of plaque localization appears to be important for stent implantation at a stenotic lesion at the carotid bifurcation.
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