A Case of Carotid Artery Stenosis Complicating Scleroderma Treated by Carotid Artery Stenting

Abstract

Objective: We treated a patient with carotid artery stenosis complicating scleroderma by carotid artery stenting (CAS) and achieved satisfactory dilation. Since scleroderma was suspected to have induced carotid artery stenosis, we report the case with a review of the literature. Case Presentation:The patient was a 75-year-old woman diagnosed with scleroderma 8 years before. She thereafter developed polymyositis, liver cirrhosis, and stenosis of the bilateral internal carotid arteries; as progression of stenosis was observed, treatment was considered necessary. In consideration of the patient's general condition, CAS by the transbrachial approach was selected. There was no complication associated with the procedure, and satisfactory dilation could be achieved. No restenosis was observed 6 months after the procedure. The history of previous disorders and the results of antibody tests strongly suggested scleroderma as a cause of carotid artery stenosis. Conclusion:We performed CAS in a patient with carotid artery stenosis suspected to have been caused by scleroderma and obtained a favorable outcome.

Bilateral popliteal artery occlusion in a young woman as a rare complication of systemic sclerosis: A case report

“…In 2011, YoheiIchimura et al described a case of SSc in a 50-year-old Japanese woman with ulnar artery stenosis, which was evaluated by magnetic resonance angiography and diminished by the bosentan treatment [2]. In 2017, Rin Shimozato et al reported a 75-year-old woman with carotid artery stenosis suspected to have been induced by SSc who was treated by carotid artery stenting (CAS) [9]. Our patient is a further case of clinical macro-vessel involvement in SSc.…”

“…There have been case reports linking the presence of anticentromere antibodies to large and medium vessel involvement. Anticentromere antibodies, smoking and drinking, older age, dyslipidemia, diabetes mellitus, and obesity are risk factors for developing macroangiopathy in SSc [9]. Anti-cardiolipin antibody (ACL) is another factor affecting large vessels and involves thrombus formation.…”