Retinal Embolization after Carotid Artery Stenting in a Monocular Patient: Clinical and Ethical Implications
- 1Department of Ophthalmology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, Maharashtra, India
Abstract
Severe carotid artery narrowing is a well-recognized cause of ischemic stroke, and carotid artery stenting (CAS) is frequently used to restore blood flow and prevent recurrence. Although embolic protection devices are designed to reduce the risk of distal embolization, ocular complications can still occur. When treating patients with vision in only one eye, any compromise in ocular circulation can have devastating consequences. A 63-year-old male presented with an acute ischemic stroke caused by severe narrowing of the Right internal carotid artery. He underwent CAS. Shortly after the procedure, he developed a sudden diminution of vision in his right eye – the only functional eye, as he had been blind in the left eye since childhood due to trauma. Ophthalmologic evaluation revealed a supratemporal branch retinal artery occlusion. Despite prompt medical management, visual recovery was minimal. This case illustrates the clinical and ethical challenge of managing cerebrovascular disease in patients at high risk of total blindness. This case highlights that retinal embolization can occur during carotid stenting and emphasizes the importance of careful patient selection, procedural vigilance, and thorough preoperative counseling – especially in individuals with monocular vision. Balancing the benefits of stroke prevention with the risk of irreversible vision loss requires a multidisciplinary and patient-centered approach.
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BibTeX
@article{bhange2026retinal,
title = {{Retinal Embolization after Carotid Artery Stenting in a Monocular Patient: Clinical and Ethical Implications}},
author = {Archana Bhange and Siddhartha Gollamudi and Himani Yadav and Gautami Laturkar},
journal = {Annals of African Medicine},
year = {2026},
month = jul,
doi = {10.4103/aam.aam_357_26},
url = {https://doi.org/10.4103/aam.aam_357_26},
note = {CC BY-NC-SA 4.0},
}
RIS
TY - JOUR
TI - Retinal Embolization after Carotid Artery Stenting in a Monocular Patient: Clinical and Ethical Implications
AU - Archana Bhange
AU - Siddhartha Gollamudi
AU - Himani Yadav
AU - Gautami Laturkar
PY - 2026
DA - 2026/07/15
JO - Annals of African Medicine
DO - 10.4103/aam.aam_357_26
UR - https://doi.org/10.4103/aam.aam_357_26
AB - Severe carotid artery narrowing is a well-recognized cause of ischemic stroke, and carotid artery stenting (CAS) is frequently used to restore blood flow and prevent recurrence. Although embolic protection devices are designed to reduce the risk of distal embolization, ocular complications can still occur. When treating patients with vision in only one eye, any compromise in ocular circulation can have devastating consequences. A 63-year-old male presented with an acute ischemic stroke caused by severe narrowing of the Right internal carotid artery. He underwent CAS. Shortly after the procedure, he developed a sudden diminution of vision in his right eye – the only functional eye, as he had been blind in the left eye since childhood due to trauma. Ophthalmologic evaluation revealed a supratemporal branch retinal artery occlusion. Despite prompt medical management, visual recovery was minimal. This case illustrates the clinical and ethical challenge of managing cerebrovascular disease in patients at high risk of total blindness. This case highlights that retinal embolization can occur during carotid stenting and emphasizes the importance of careful patient selection, procedural vigilance, and thorough preoperative counseling – especially in individuals with monocular vision. Balancing the benefits of stroke prevention with the risk of irreversible vision loss requires a multidisciplinary and patient-centered approach.
SN - 1596-3519
SN - 0975-5764
ER -