Carotid Stenting with Tortuous Arch
An 82-year-old female presented with transient weakness of the right arm. MRI brain was normal. However, MRA revealed severe stenosis of bilateral ICA (Fig. 97.1a, b). The left CCA was rising at an acute angle from the brachiocephalic artery (Fig. 97.1c). Patient had received radiotherapy in neck region for laryngeal tumor 12 years back. As left ICA stenosis was symptomatic, revascularization was planned, and, in view of previous radiotherapy, endovascular approach was favored over endarterectomy.