Retinal artery embolization after carotid artery stenting: report of a case and review of literature

Background: Retinal artery occlusion is an uncommon but serious complication during carotid artery stenting (CAS) for carotid artery stenosis, which induces the visual defect in patients. Case presentation: A 74-yearold man was admitted to our hospital because of intermittent dizziness and limb weakness in the past one month. Cerebral angiography revealed 86% stenosis on the start of the right internal carotid artery. CAS was scheduled with a distal protection device after once pre-ballooning, and then two post-ballooning. The next day after the CAS, the patient complained of blurred vision in the right eye and was diagnosed with the occlusion of branch of central retinal artery under fluorescein retinal angiography. The vision of this patient was partially recovered and discharged after Hess expansion, compound anisodine injection beside the superficial temporal artery, dexamethasone, lidocaine and atropine retrobulbar injection, and hyperbaric oxygen therapy. After 3 months, the fluorescein retinal angiograms showed the elimination of the retina edema and recovery of blood supply. Conclusions: This study suggests that a serial of treatment approaches may improve the visual defect and resolve the retina edema.