Usefulness of transoral carotid ultrasonography: a case report on stenting for internal carotid artery dissection

Background and Purpose: Transoral carotid ultrasonography (TOCU) can examine cervical internal carotid artery (ICA) in a higher position. We report a case of a patient with stenting of idiopathic cervical internal artery dissections, and we evaluated the application of TOCU. Case: A 58-year-old man was admitted to our hospital for posterior headache and left Horner syndrome. Computed tomography angiography revealed an enlargement of left ICA and a severe stenosis at C4 portion of left ICA. No worsening of neurological symptoms was observed, however, magnetic resonance angiography revealed a progression of stenosis of left cervical ICA. On day 5, endovascular stenting with three Wingspan and one Enterprise intracranial stents was performed. The angiogram indicated complete coverage of the stenotic segment by the stents. TOCU demonstrated blood flow in color Doppler through the stents. He discharged from hospital with modified Rankin Scale 0. Conclusions: TOCU can be a useful clinical method for an evaluation after stenting of cervical ICA dissection.