Okada Y, Oishi R, Kimura S, Egi M. Anesthetic and procedural strategy for coexisting severe aortic stenosis and carotid artery stenosis: A case report. World J Surg Proced 2026; 16(1): 115792 [DOI: 10.5412/wjsp.v16.i1.115792]
Corresponding Author of This Article
Satoshi Kimura, MD, MPH, PhD, Department of Anesthesiology, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan. kimsato1034@hotmail.co.jp
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Anesthesiology
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Case Report
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Jan 16, 2026 (publication date) through Jan 15, 2026
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World Journal of Surgical Procedures
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2219-2832
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Okada Y, Oishi R, Kimura S, Egi M. Anesthetic and procedural strategy for coexisting severe aortic stenosis and carotid artery stenosis: A case report. World J Surg Proced 2026; 16(1): 115792 [DOI: 10.5412/wjsp.v16.i1.115792]
World J Surg Proced. Jan 16, 2026; 16(1): 115792 Published online Jan 16, 2026. doi: 10.5412/wjsp.v16.i1.115792
Anesthetic and procedural strategy for coexisting severe aortic stenosis and carotid artery stenosis: A case report
Yuri Okada, Rio Oishi, Satoshi Kimura, Moritoki Egi
Yuri Okada, Rio Oishi, Satoshi Kimura, Moritoki Egi, Department of Anesthesiology, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan
Author contributions: Okada Y, Oishi R, and Kimura S treated the patients; Okada Y, Oishi R, and Kimura S wrote the manuscript; Egi M helped in designing the case report; and all authors have reviewed and approved the final draft of the manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Satoshi Kimura, MD, MPH, PhD, Department of Anesthesiology, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan. kimsato1034@hotmail.co.jp
Received: October 31, 2025 Revised: November 23, 2025 Accepted: December 12, 2025 Published online: January 16, 2026 Processing time: 78 Days and 5.5 Hours
Abstract
BACKGROUND
Aortic stenosis (AS) often coexists with carotid artery stenosis. However, clear guidelines for the optimal treatment strategy and sequencing of interventions in patients with both conditions are lacking.
CASE SUMMARY
A 79-year-old man with a history of hypertension presented with right-sided paralysis and pain. Magnetic resonance imaging revealed multiple infarctions in the left cerebral hemisphere and severe stenosis of the left carotid artery. Transthoracic echocardiography also identified coexisting severe AS. Carotid artery stenosis increases the risk of stroke during aortic valve manipulation; therefore, carotid intervention may be recommended prior to aortic valve treatment. However, perioperative hypotension and bradycardia associated with carotid intervention can precipitate circulatory collapse in patients with severe AS. After a multidisciplinary conference, the decision was made to first perform transcatheter aortic valve implantation under general anesthesia, followed by carotid endarterectomy 4 months later. Both procedures were completed successfully without complications.
CONCLUSION
Treatment strategy should be individualized, balancing perioperative risks and benefits in patients with severe AS and carotid artery stenosis.
Core Tip: Aortic stenosis (AS) often coexists with carotid artery stenosis. The treatment strategy for patients with coexisting severe AS and carotid artery stenosis should be individualized, weighing the perioperative risks and benefits of each planned intervention.
