Two cases of cerebral vasospasm after carotid artery stenting

Abstract

We report two cases of diffuse vasospasm on the affected side after carotid artery stenting (CAS). Thromboembolism is the most common ischemic complication, but cerebral vasospasm has also been reported in rare cases. Both patients had symptomatic stenosis. Case 1 had a severe stenosis with a high probability of reduced cerebral vascular reserve. Case 2 had moderate stenosis with no loss of vascular reserve, and single-photon emission computed tomography immediately after CAS showed extensive hypoperfusion in the affected cerebral hemisphere. Cerebral vasospasm, along with hyperperfusion syndrome, is a condition that causes changes in cerebral blood flow and requires prompt diagnosis because the treatment is different. It is important to differentiate ischemic complications after CAS by considering not only thromboembolism but also this condition.