PURPOSE A 67-year-old man with an embolic branch retinal artery occlusion occurring as a complication of internal carotid artery stenting, despite the use of a distal filter cerebral protection device was reported.
METHODS Observational case report. One patient case is included in this case report.
RESULTS The patient developed a branch retinal arterial occlusion with visible emboli 24 hours after a carotid angioplasty and stenting procedure and was found to have multiple anastomoses between the external carotid artery and ophthalmic artery as a result of carotid stenosis. He required a second, emergent angioplastic procedure.
CONCLUSION External carotid-ophthalmic arterial anastomoses can act as a pathway for emboli to travel from the internal carotid artery to the retinal circulation, resulting in retinal arterial occlusions, despite the use of cerebral protective devices. Ophthalmologists and interventional radiologists should be aware of these factors, especially as the number of percutaneous carotid artery stenting procedures continues to increase.