It was reported that a left transcarotid artery revascularization (tcar) was performed on a (b)(6) year old symptomatic male, under regional block and light conscious sedation.The patient was fully respondent post clamping until pre dilation.Just after stent deployment, the patient was very slow to respond to voice commands.A discussion of sedation vs intolerance occurred.After a two minute wait period, an angiogram was performed showing successful stent deployment with full patency.The physician pulled the guidewire and unclamped.The patient slowly become more arousable but still showed cognition impairment.Upon completion of closure, the patient continued to improve and was responding to commands, but unable to make first contralaterally.A decision to notify neuro was made to evaluate for potential stroke.Neuro exam showed mild aphasia with extremity weakness and cognition impairment.A computed tomography (ct scan) showed no evidence of embolic obstruction or hemorrhagic event.The patient was still improving 6 hours post procedure.Magnetic resonance angiography (mra) showed multiple acute amboli.No additional details were provided.
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