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Carotid artery stenting

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https://www.readbyqxmd.com/read/29049819/treatment-of-a-degenerated-sutureless-sorin-perceval%C3%A2-valve-using-an-edwards-sapien-3
#1
Norman Mangner, David Holzhey, Martin Misfeld, Axel Linke
Valve-in-valve implantation is an alternative to reoperation for patients with degenerated bioprostheses. This case report presents a 75-year-old woman presenting with worsening dyspnoea according New York Heart Association (NYHA) Class III after she had received a Sorin Perceval® S sutureless valve due to severe aortic valve stenosis 5 years ago. Echocardiography revealed a degenerated Perceval valve with severe valvular aortic regurgitation and stenosis. After exclusion of acute infective endocarditis, an Edwards SAPIEN 3 was implanted leading to an immediate haemodynamic improvement...
October 10, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29049809/association-of-quality-improvement-registry-participation-with-appropriate-follow-up-after-vascular-procedures
#2
Benjamin S Brooke, Adam W Beck, Larry W Kraiss, Andrew W Hoel, Andrea M Austin, Amir A Ghaffarian, Jack L Cronenwett, Philip P Goodney
Importance: Ensuring that patients undergo surveillance imaging after surgery is a key quality metric after many vascular procedures. It is unclear whether hospital participation in a national quality improvement registry such as the Vascular Quality Initiative (VQI) achieves this goal. Objective: To determine if hospital participation in the VQI registry is associated with increased rates of surveillance imaging after vascular procedures. Design, Setting, and Participants: A quasi-experimental study used Medicare claims to study 2174 US hospitals in which 1 530 102 patients had undergone an endovascular abdominal aortic aneurysm repair (EVAR), 1 403 067 patients had undergone a lower extremity bypass (LEB) or peripheral vascular intervention (PVI), and 294 942 patients had undergone carotid endarterectomy (CEA) and carotid artery stenting (CAS) procedures between January 1, 2007, and December 31, 2012...
October 11, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/29049795/establishing-stable-innominate-access-by-inserting-a-body-floss-wire-from-the-brachial-artery-to-the-femoral-artery-facilitates-right-carotid-artery-stenting-in-type-iii-arch-anatomy
#3
Ming-Jen Kuo, Po-Lin Chen, Chun-Che Shih, I-Ming Chen
OBJECTIVES: In patients with severe carotid artery stenosis, the anatomy of their Type III aortic arch increases the difficulty and complication rates during carotid artery stenting because of its tortuosity and sharp angulation for cannulation as well as the unstable support of the guidewire for shuttle sheath delivery. METHODS: We demonstrate a novel technique to overcome these challenges, namely the creation of stable innominate artery access by inserting a through-and-through body floss wire from the right brachial artery to the femoral artery...
August 17, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29046918/flow-diverter-treatment-of-cerebral-blister-aneurysms
#4
Russell Cerejo, Mark Bain, Seby John, Julian Hardman, Nina Moore, M Shazam Hussain, Gabor Toth
PURPOSE: Blood blister-like aneurysms (BBA) are small, friable, broad-based aneurysms that represent high risk for rerupture. Treatment of BBA is challenging, and may include surgical wrapping, clipping, multiple overlapping stents, and/or coiling. Flow diversion is a rapidly evolving treatment strategy for intracranial aneurysms, but the evidence for its use in cases of BBA is scarce. METHODS: A retrospective review of flow-diverter-treated, ruptured BBA cases at our tertiary care institution was undertaken...
October 18, 2017: Neuroradiology
https://www.readbyqxmd.com/read/29046465/-usefulness-of-bilateral-rso-sub-2-sub-monitoring-for-predicting-cerebral-hyperperfusion-syndrome-after-carotid-artery-stenting
#5
Jun Niimi, Shoichiro Ishihara, Eisuke Tsukagoshi, Hiroaki Neki, Yoshiaki Kakehi, Nahoko Uemiya, Kouji Mizokami, Hideaki Ishihara, Shinya Kohyama, Fumitaka Yamane
OBJECTIVE: Cerebral hyperperfusion syndrome(CHS)and cerebral hyperperfusion phenomenon(CHP)induce intracranial hemorrhage and can become critical complications after carotid artery stenting(CAS). The purpose of the present study was to predict and avoid CHS after CAS using bilateral rSO<sub>2</sub> intraoperative monitoring. METHODS: We retrospectively analyzed 100 consecutive patients who underwent CAS between January 2012 and May 2014 in our institution...
October 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/29044926/optical-coherence-tomography-guided-carotid-artery-stent-procedure-technique-and-potential-applications
#6
Suhail Dohad, Alexander Zhu, Sandeep Krishnan, Frances Wang, Serena Wang, Justin Cox, Timothy D Henry
OBJECTIVES: To (1) present a guide on how to perform optical coherence tomography (OCT) in carotid artery stenting (CAS), to (2) highlight several instructive cases illustrating OCT-guidance as an interventional strategy, and to (3) present the largest case-series of OCT-guided CAS performed in North America, demonstrating its feasibility as an imaging modality in this setting. BACKGROUND: OCT is an intravascular imaging method that captures images with an axial resolution 10 times higher than intravascular ultrasound...
October 16, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29038409/-total-arch-replacement-for-distal-arch-aneurysm-with-isolated-left-vertebral-artery-report-of-a-case
#7
Motonori Uchino, Masaru Yoshikai, Hisashi Sato, Jun Osaki
We herein present a case of distal aortic arch aneurysm with an isolated left vertebral artery(LVA). In surgery, after establishing cardiopulmonary bypass, the LVA was anastomosed to the left common carotid artery (LCCA) while under moderate hypothermia. Selective cerebral perfusion (SCP) was then initiated by inserting catheters into the brachiocephalic artery( BCA), the LCCA and the left subclavian artery (LSA). The aorta was transected between the BCA and the LCCA, and an open stent graft was deployed into the descending aorta during circulatory arrest...
October 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29034021/endovascular-repair-for-kommerell-s-diverticulum-and-right-sided-aortic-arch
#8
Kei Kazuno, Seiichiro Murata
A 74-year-old man with hoarseness was diagnosed with a right-sided aortic arch and Kommerell's diverticulum by computed tomography (CT). The diverticulum had a maximum diameter of 33 mm, and surgical intervention was chosen because of the possibility of rupture. A right common carotid to right subclavian artery bypass was constructed, stent-graft was placed after the branching of the right common carotid artery, and coil embolization of the diverticulum was performed via left brachial artery. No leaks were found on postoperative CT...
March 24, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29032862/endovascular-treatment-of-acute-tandem-occlusion-strokes-and-stenting-first-experience
#9
Süha Akpınar, Pınar Gelener
This study demonstrates the radiologic and clinical findings, etiologies and intervention strategy in 8 acute ischemic stroke patients with tandem occlusions. The mean age was 57 and mean NIHSS score was 19. Stent-assisted thrombectomy (SAT) was performed on all of the patients. Additionally, 6 patients underwent carotid artery stenting before SAT. Recanalization with TICI≥2b was attained in 7/8 patients. The 90thday median mRS was 2 and mortality was 1/8. The etiologies of the tandem occlusions were either extracranial high grade ICA stenosis/occlusion or cervical ICA dissection...
October 9, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29030499/unexpected-early-radiographic-findings-associated-with-a-ruptured-blister-like-carotid-wall-aneurysm
#10
James West, Jasmeet Singh, Stacey Q Wolfe, Kyle M Fargen
A 33-year-old man presented with aneurysmal subarachnoid hemorrhage from a ruptured, blister-type sidewall internal carotid artery (ICA) aneurysm. Balloon-assisted coiling was performed with residual neck. He subsequently developed severe vasospasm requiring intra-arterial therapies on multiple occasions, during which it was noted that despite widespread vasospasm, a focal segment of the ICA at the site of the aneurysm showed no significant spasm, suggesting underlying vessel abnormality. He was discharged without deficit and scheduled for flow diversion given concern over this potentially pathologic segment of vessel...
October 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29025747/uncoupling-protein-2-inhibits-myointimal-hyperplasia-in-preclinical-animal-models-of-vascular-injury
#11
Yan Zhang, Yaolei Zhang, Wei Li, Peijian Wang, Rui Gu, Yaxing Feng, Shujie Wei, Ke Peng, Yunrong Zhang, Linan Su, Qiang Wang, De Li, Dachun Yang, Wing Tak Wong, Yongjian Yang, Shuangtao Ma
BACKGROUND: Intracoronary stent restenosis, characterized by excessive smooth muscle cell (SMC) proliferation and myointimal hyperplasia, remains a clinical challenge. Mitochondrial membrane potential has been linked to the proliferative rate of SMCs. This study aimed to screen a critical gene regulating mitochondrial potential and to confirm its effects on myointimal formation in preclinical animal models. METHODS AND RESULTS: We performed transcriptome screening for genes differentially expressed in ligated versus unligated mouse carotid arteries...
October 12, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29021357/radiographic-and-symptomatic-brain-ischemia-in-cea-and-cas-a-systematic-review-and-meta-analysis
#12
Sung-Min Cho, Abhishek Deshpande, Vinay Pasupuleti, Adrian V Hernandez, Ken Uchino
OBJECTIVE: In a systematic review, we compared ratio of new periprocedural radiographic brain ischemia (RBI) to the number of strokes and TIAs among patients undergoing carotid endarterectomy (CEA) and carotid artery stenting (CAS). METHODS: We searched 5 databases for entries related to brain ischemia in CEA or CAS from inception through September 2015. We included articles with CEA or CAS and systematic performance of preprocedural and postprocedural brain MRI and reporting of RBI and stroke incidence...
October 11, 2017: Neurology
https://www.readbyqxmd.com/read/29021314/augmented-3d-venous-navigation-for-neuroendovascular-procedures
#13
Raphaël Blanc, Robert Fahed, Pascal Roux, Stanislas Smajda, Gabriele Ciccio, Jean-Philippe Desilles, Hocine Redjem, Mikael Mazighi, Humain Baharvahdat, Michel Piotin
BACKGROUND: Endovascular venous access is increasingly used for the treatment of many cerebrovascular diseases. The quality of venous roadmapping through arterial injection can be problematic because of contrast media dilution, slow flow velocity, and unilateral opacification of the venous system. OBJECTIVE: To describe our experience with the VesselNavigator (Philips Healthcare, Best, The Netherlands) in performing live 3D roadmapping for intracranial venous procedures...
October 11, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29021311/acute-ischemic-stroke-with-tandem-lesions-technical-endovascular-management-and-clinical-outcomes-from-the-escape-trial
#14
Zarina Assis, Bijoy K Menon, Mayank Goyal, Andrew M Demchuk, Jai Shankar, Jeremy L Rempel, Daniel Roy, Alexander Y Poppe, Victor Yang, Cheemun Lum, Dar Dowlatshahi, John Thornton, Hana Choe, Paul A Burns, Donald F Frei, Blaise W Baxter, Michael D Hill
BACKGROUND: Tandem occlusions of the extracranial carotid and intracranial carotid or middle cerebral artery have a particularly poor prognosis without treatment. Several management strategies have been used with no clear consensus recommendations. We examined subjects with tandem occlusions enrolled in the ESCAPE trial and their outcomes. METHODS: Data are from the ESCAPE trial. Additional data were sought on interventions for each subject. RESULTS: There were 54 (17%) subjects with tandem extracranial and intracranial occlusions...
October 11, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29019319/the-asymptomatic-carotid-surgery-trial-2-acst-2-an-ongoing-randomised-controlled-trial-comparing-carotid-endarterectomy-with-carotid-artery-stenting-to-prevent-stroke
#15
Richard Bulbulia, Alison Halliday
BACKGROUND: A successful open surgical operation to remove atheromatous carotid artery narrowing that has not yet caused a stroke (asymptomatic carotid stenosis) carries some procedural risk but, if completed successfully, halves patients' future annual stroke risk for at least 10 years. A newer, less invasive alternative is carotid stenting, which also carries some procedural risk, especially if the carotid lesion has recently given rise to a stroke (symptomatic carotid stenosis). For both surgery and stenting, improvements in technique (and in medication) have reduced risk...
October 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29018649/rapid-recanalization-using-trevoprovue-through-a-4-2-fr-catheter-without-a-guiding-catheter-via-transbrachial-approach-a-case-report
#16
Susumu Yamaguchi, Nobutaka Horie, Yoichi Morofuji, Kei Satoh, Kazuhiko Suyama
Mechanical thrombectomy with a stent retriever has been reported to achieve high rates of successful recanalization, and reduce disability and mortality in patients with acute ischemic stroke (AIS) due to proximal vessel occlusion. However, in a few cases, the treatment is difficult due to artery tortuosity or other factors. The authors present a case of a 94-year-old man presenting with acute right middle cerebral artery occlusion. We attempted to treat using a stent retriever via transfemoral approach, but failed to advance the guiding catheter into the right internal carotid artery due to femoral artery tortuosity and a type III arch...
October 2017: NMC Case Rep J
https://www.readbyqxmd.com/read/29018133/carotid-web-intimal-fibromuscular-dysplasia-has-high-stroke-recurrence-risk-and-is-amenable-to-stenting
#17
Diogo C Haussen, Jonathan A Grossberg, Mehdi Bouslama, Gustavo Pradilla, Samir Belagaje, Nicolas Bianchi, Jason W Allen, Michael Frankel, Raul G Nogueira
BACKGROUND AND PURPOSE: Carotid webs have been increasingly recognized as a cause of recurrent stroke, but evidence remains scarce. We aim to report the clinical outcomes and first series of carotid stenting in a cohort of patients with strokes from symptomatic carotid webs. METHODS: Prospective and consecutive data of patients <65 years old with cryptogenic stroke admitted within September 2014 to May 2017. Carotid web was defined by a shelf-like/linear filling defect in the posterior internal carotid artery bulb by computed tomographic angiography...
October 10, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28994833/the-efficacy-and-safety-of-endovascular-recanalization-of-occluded-large-cerebral-arteries-during-the-subacute-phase-of-cerebral-infarction-a-case-series-report
#18
Kangning Chen, Xianhua Hou, Zhenhua Zhou, Guangjian Li, Qu Liu, Li Gui, Jun Hu, Shugui Shi
BACKGROUND: Intravenous tissue plasminogen activator with or without mechanical thrombectomy during the acute phase are approved therapies for ischaemic stroke. Due to the short treatment time window (<6 hours) and often treatment failure, these patients would still have an intracranial arterial occlusion (IAO). It is unclear whether these patients can benefit from subsequent interventional recanalizationof their occluded artery in the subacute phase. In this retrospective study, we have examined the efficacy and safety in patients who have received either percutaneous transluminal angioplasty (PTA) or percutaneous transluminal angioplasty and stenting (PTAS) for IAO in the subacute phase of their stroke...
September 2017: Stroke and Vascular Neurology
https://www.readbyqxmd.com/read/28994832/carotid-endarterectomy-for-treatment-of-carotid-in-stent-restenosis-long-term-follow-up-results-and-surgery-experiences-from-one-single-centre
#19
Le-Bao Yu, Wei Yan, Qian Zhang, Ji-Zong Zhao, Yan Zhang, Rong Wang, Jun-Shi Shao, Dong Zhang
OBJECTIVE: Few studies have reported the surgical treatment of carotid in-stent restenosis (ISR), more data and longer follow-up are needed. We describe the surgical treatment of ISR by standard carotid endarterectomy (CEA) with stent removal, including long-term follow-up in 10 patients from our centre. METHODS: Ten patients from our centre who underwent CEA with stent removal for ISR were retrospectively analysed, including nine symptomatic and one asymptomatic ISR of at least 70% with mean age 67...
September 2017: Stroke and Vascular Neurology
https://www.readbyqxmd.com/read/28982691/carotid-stent-fractures-are-not-associated-with-adverse-events-results-from-the-act-1-multicenter-randomized-trial
#20
Ido Weinberg, Joshua A Beckman, Jon S Matsumura, Kenneth Rosenfield, Gary Ansel, Seemant Chaturvedi, William A Gray, D Chris Metzger, Tom S Riles, Yu Shu, Lawrence R Wechsler, Michael R Jaff
Background -The impact of carotid artery stent fractures on the incidence of adverse clinical events remains unclear. The objective of this study is to report the stent fracture rate and its association with in-stent restenosis and adverse outcomes in the Asymptomatic Carotid Trial (ACT)-1. Methods -ACT-1 is a prospective multicenter trial of standard surgical risk patients with severe asymptomatic carotid artery stenosis randomized to carotid artery stenting (CAS) or carotid endarterectomy (CEA) (Abbott Vascular, Santa Clara, California, USA)...
October 5, 2017: Circulation
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