Transoral carotid ultrasonography using superb microvascular imaging of carotid artery stenting in cervical internal carotid artery dissection: a case report

Abstract

Transoral carotid ultrasonography (TOCU) is a powerful tool for evaluating the high internal carotid artery (ICA). Multiple reports have documented its excellent ability to show dissection of the high ICA. Superb microvascular imaging (SMI) is a new Doppler imaging technique that reduced motion artifacts and allows visualization of low-velocity blood flow in vessels. A 45-year-old man with aphasia and right hemiplegia was brought to our hospital. MRI showed acute cerebral infarction, and he was treated by recombinant tissue plasminogen activator (rt-PA). A carotid angiogram showed the dissection of the left extracranial ICA, and carotid artery stenting of the left ICA was performed. Postoperative SMI-TOCU showed that blood flow was preserved with no stenosis. It seemed that a part was missing. This was caused by slight turbulence caused by the step of the stent. The present case suggests that post-procedure evaluation by SMI-TOCU for carotid artery stenting in ICA dissection may be useful.