Endovascular therapy in a complex patient with critical carotid stenosis and chronic kidney disease

Atherosclerosis is a chronic inflammatory disease of the arteries in which their walls progressively thicken as a result of the accumulation of various substances, including fats, calcium, and blood cells. This leads to atherosclerosis, which results in areas of stenosis of varying degrees. Diabetes is associated with macrovascular complications, such as ischemic heart disease, cerebrovascular disease, atheromatous carotid artery disease, and peripheral arterial disease, factors that simultaneously affect kidney function. Several specific mechanisms associated with diabetes promote atherosclerosis: hyperglycemia, lipid metabolism disorders, insulin resistance, increased oxidative stress, proinflammatory cytokine release, coagulation disorders, fibrinolysis, and endothelial dysfunction. We present the case of a female patient in her seventh decade of life with acute chronic kidney disease, critical left carotid artery stenosis, type 2 diabetes and arterial hypertension, mixed heart disease with bilateral pleural effusion and pericardial effusion, and with a pacemaker, who underwent successful carotid artery stenting via a neurological endovascular approach. This case, one of the first of its kind, was performed privately in the city of Uruapan, Michoacán, Mexico.