Figure 1 Preoperative head imaging findings on the first admission CTA showed that the M1 segment of right MCA occlusion (arrow indicates, Panel 1a). Axial DWI showed that acute cerebral infarction in the right frontal parietal lobe (arrow indicates, Panel 1b).

Figure 2 Lateral DSA findings before and after operation on the first admission Preoperative DSA showed the M1 segment of right MCA occlusion (arrow indicates, Panel 2a). Postoperative DSA showed re-opening of the right MCA occlusion segment (Panel 2b).

Figure 3 Light microscopy showed hyperplasia of fibrous tissue with mucinous degeneration (arrow indicates). HE staining Low power magnified

Figure 4 Carotid ultrasound on the first admission showed carotid webbing in the right carotid artery bifurcation (arrows indicate). Brachy axial section (Panel 4a). Long axial section (Panel 4b).

Figure 5 Imaging findings before and after operation on the second admission Preoperative head and neck CTA showed carotid webbing in the right carotid artery bifurcation (arrow indicates, Panel 5a). Preoperative anteroposterior DSA showed right MCA occlusion (arrow indicates, Panel 5b). Postoperative anteroposterior DSA showed right MCA recanalization (Panel 5c).

Figure 6 Postoperative head MRI findings on the second admission showed cerebral infarction in the right paraventricular. Axial DWI (Panel 6a). Axial ADC (Panel 6b). Axial T2-FLAIR (Panel 6c).

Figure 7 Lateral DSA findings before and after surgery on the third admission Preoperative DSA showed a membrane-like filling defect in the posterior wall at the beginning of the right ICA (arrow indicates, Panel 7a). Postoperative DSA showed no filling defect was found after stent implantation, and the stent adhered well to the wall (Panel 7b).