Rapid Regression of Carotid Artery Stenosis Shortly after Intensive Medical Therapy
Carotid artery stenosis (CAS) is mainly caused by atherosclerosis. Intensive medical therapy is effective in preventing stroke in CAS. To date, there has been no published report of rapid regression of CAS. A woman with untreated hyperlipidemia visited our emergency room with left hemiparesis. She e...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-02-01
|
| Series: | Tomography |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2379-139X/8/1/44 |
| _version_ | 1827652551426703360 |
|---|---|
| author | Suh Yeon Park Sang Hun Rhi Ji Yeon Chung Chan-Hyuk Lee Byoung-Soo Shin Hyun Goo Kang |
| author_facet | Suh Yeon Park Sang Hun Rhi Ji Yeon Chung Chan-Hyuk Lee Byoung-Soo Shin Hyun Goo Kang |
| author_sort | Suh Yeon Park |
| collection | DOAJ |
| description | Carotid artery stenosis (CAS) is mainly caused by atherosclerosis. Intensive medical therapy is effective in preventing stroke in CAS. To date, there has been no published report of rapid regression of CAS. A woman with untreated hyperlipidemia visited our emergency room with left hemiparesis. She exhibited facial palsy, left hemiparesis, and dysarthria immediately after the visit. Brain magnetic resonance (MR) diffusion-weighted imaging confirmed acute infarction in the right middle cerebral artery (MCA) territory due to severe stenosis of the right internal carotid artery (ICA), which was revealed by MR angiography and carotid duplex ultrasonography. The patient started intensive statin therapy and dual antiplatelet agent therapy. Carotid artery stenting was not performed until hospitalization day 16 due to pleural effusion. On day 16, digital subtraction angiography was performed, and spontaneous regression of severe stenosis was observed. Only mild stenosis with ulcerative plaque was evident. The rapid CAS regression in this case may be caused by M2 macrophage polarization as a result of intensive statin therapy. This rapid regression may also result from reduced foam cell formation by statin and aspirin and thereby increased endogenous thrombolysis. Our patient demonstrated the efficacy of short-term intensive statin and aspirin therapy on atherosclerosis with untreated hyperlipidemia. |
| first_indexed | 2024-03-09T20:57:00Z |
| format | Article |
| id | doaj.art-fa2acea01e9140ab9bbd5e0fa0bf795d |
| institution | Directory Open Access Journal |
| issn | 2379-1381 2379-139X |
| language | English |
| last_indexed | 2024-03-09T20:57:00Z |
| publishDate | 2022-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Tomography |
| spelling | doaj.art-fa2acea01e9140ab9bbd5e0fa0bf795d2023-11-23T22:19:54ZengMDPI AGTomography2379-13812379-139X2022-02-018154354910.3390/tomography8010044Rapid Regression of Carotid Artery Stenosis Shortly after Intensive Medical TherapySuh Yeon Park0Sang Hun Rhi1Ji Yeon Chung2Chan-Hyuk Lee3Byoung-Soo Shin4Hyun Goo Kang5Jeonbuk National University Medical School, Jeonju 54907, KoreaJeonbuk National University Medical School, Jeonju 54907, KoreaDepartment of Neurology, Chosun University Medical School, Gwangju 61453, KoreaDepartment of Neurology, Jeonbuk National University Hospital, Jeonju 54907, KoreaDepartment of Neurology, Jeonbuk National University Hospital, Jeonju 54907, KoreaDepartment of Neurology, Jeonbuk National University Hospital, Jeonju 54907, KoreaCarotid artery stenosis (CAS) is mainly caused by atherosclerosis. Intensive medical therapy is effective in preventing stroke in CAS. To date, there has been no published report of rapid regression of CAS. A woman with untreated hyperlipidemia visited our emergency room with left hemiparesis. She exhibited facial palsy, left hemiparesis, and dysarthria immediately after the visit. Brain magnetic resonance (MR) diffusion-weighted imaging confirmed acute infarction in the right middle cerebral artery (MCA) territory due to severe stenosis of the right internal carotid artery (ICA), which was revealed by MR angiography and carotid duplex ultrasonography. The patient started intensive statin therapy and dual antiplatelet agent therapy. Carotid artery stenting was not performed until hospitalization day 16 due to pleural effusion. On day 16, digital subtraction angiography was performed, and spontaneous regression of severe stenosis was observed. Only mild stenosis with ulcerative plaque was evident. The rapid CAS regression in this case may be caused by M2 macrophage polarization as a result of intensive statin therapy. This rapid regression may also result from reduced foam cell formation by statin and aspirin and thereby increased endogenous thrombolysis. Our patient demonstrated the efficacy of short-term intensive statin and aspirin therapy on atherosclerosis with untreated hyperlipidemia.https://www.mdpi.com/2379-139X/8/1/44carotid stenosisatherosclerosishyperlipidemiasstatinaspirin |
| spellingShingle | Suh Yeon Park Sang Hun Rhi Ji Yeon Chung Chan-Hyuk Lee Byoung-Soo Shin Hyun Goo Kang Rapid Regression of Carotid Artery Stenosis Shortly after Intensive Medical Therapy Tomography carotid stenosis atherosclerosis hyperlipidemias statin aspirin |
| title | Rapid Regression of Carotid Artery Stenosis Shortly after Intensive Medical Therapy |
| title_full | Rapid Regression of Carotid Artery Stenosis Shortly after Intensive Medical Therapy |
| title_fullStr | Rapid Regression of Carotid Artery Stenosis Shortly after Intensive Medical Therapy |
| title_full_unstemmed | Rapid Regression of Carotid Artery Stenosis Shortly after Intensive Medical Therapy |
| title_short | Rapid Regression of Carotid Artery Stenosis Shortly after Intensive Medical Therapy |
| title_sort | rapid regression of carotid artery stenosis shortly after intensive medical therapy |
| topic | carotid stenosis atherosclerosis hyperlipidemias statin aspirin |
| url | https://www.mdpi.com/2379-139X/8/1/44 |
| work_keys_str_mv | AT suhyeonpark rapidregressionofcarotidarterystenosisshortlyafterintensivemedicaltherapy AT sanghunrhi rapidregressionofcarotidarterystenosisshortlyafterintensivemedicaltherapy AT jiyeonchung rapidregressionofcarotidarterystenosisshortlyafterintensivemedicaltherapy AT chanhyuklee rapidregressionofcarotidarterystenosisshortlyafterintensivemedicaltherapy AT byoungsooshin rapidregressionofcarotidarterystenosisshortlyafterintensivemedicaltherapy AT hyungookang rapidregressionofcarotidarterystenosisshortlyafterintensivemedicaltherapy |