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Carotid artery stenting

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https://www.readbyqxmd.com/read/27908821/carotid-bypass-using-gore-hybrid-vascular-graft-for-in-stent-restenosis-after-carotid-stenting
#1
Andrea Agostinucci, Andrea Cumino, Roberta Suita, Andrea Bellan, Davide Lazzaro, Elisa Pagliasso, Ferruccio Ferrero
In-stent restenosis (ISR) is the most common long-term complication following Carotid Artery Stenting (CAS), affecting 3.5% to 21% of patients after a mean follow up of 18 months in published reports. Until now, the optimal management for ISR after CAS is still not clear and different endovascular treatments along with various surgical options have been proposed. Moreover, surgical treatment for ISR in a previously operated patient of ipsilateral endarterectomy is a technically demanding procedure. In this report, we describe a case of severe carotid recurrent ISR, which occurred after CAS for post-endarterectomy restenosis, that was successfully treated, in a straightforward way, with a carotid bypass using a Gore(®) Hybrid Vascular Graft...
November 28, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27906117/carotid-artery-stenting-versus-no-stenting-assisting-thrombectomy-for-acute-ischaemic-stroke-protocol-for-a-systematic-review-of-randomised-clinical-trials-with-meta-analyses-and-trial-sequential-analyses
#2
Henrik Steglich-Arnholm, Markus Holtmannspötter, Christian Gluud, Derk Wolfgang Krieger
BACKGROUND: In patients with intracranial large vessel arterial occlusion, ipsilateral extracranial carotid artery occlusions or near-occlusions pose a significant hurdle in endovascular management of acute ischaemic stroke. Stenting of the carotid lesion may be beneficial in this situation to provide a stable access for introducing catheters through the carotid lesion into the intracranial vasculature and the target occlusion. Furthermore, carotid stenting may ensure ample blood flow for wash-out of clot material and reperfusion of the ischaemic penumbral tissue...
December 1, 2016: Systematic Reviews
https://www.readbyqxmd.com/read/27905692/remote-pre-procedural-ischemic-stroke-was-the-strongest-risk-for-stroke-and-death-associated-with-carotid-stenting-a-single-center-experience
#3
Mária Rašiová, Ľubomír Špak, Ľudmila Farkašová, Štefan Pataky, Martin Koščo, Marek Hudák, Matej Moščovič, Norbert Leško
BACKGROUND: The goal of carotid artery stenting (CAS) is to decrease the stroke risk in patients with carotid stenosis. This procedure carries an immediate risk of stroke and death and many patients do not benefit from it, especially asymptomatic patients. Patient selection for carotid procedure who benefit from procedure and who is the procedure hazardous for is important. Remote ischemic stroke is known risk factor for stroke reccurence during surgery. The aim of our study was to determine the periprocedural complication risk (within 30 days after CAS) associated with carotid stenting (stroke, death) between patients with remote pre- procedural ischemic stroke and without it; to analyse periprocedural risk in other specific patient subgroups treated with CAS and to determine the impact of observed variables on all- cause mortality during long-term follow-up...
December 1, 2016: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/27904445/endovascular-treatment-of-unruptured-aneurysms-of-cavernous-and-ophthalmic-segment-of-internal-carotid-artery-with-flow-diverter-device-pipeline
#4
Marko Jevsek, Charbel Mounayer, Tomaz Seruga
BACKGROUND: Intra-arterial treatment of aneurysms by redirecting blood flow is a newer method. The redirection is based on a significantly more densely braided wire stent. The stent wall keeps the blood in the lumen of the stent and slows down the turbulent flow in the aneurysms. Stagnation of blood in the aneurysm sac leads to the formation of thrombus and subsequent exclusion of the aneurysm from the circulation. The aim of the study was to evaluate flow diverter device Pipeline for broad neck and giant aneurysm treatment...
December 1, 2016: Radiology and Oncology
https://www.readbyqxmd.com/read/27900766/contemporary-management-of-carotid-blowout-syndrome-utilizing-endovascular-techniques
#5
Nauman F Manzoor, Rod P Rezaee, Abhishek Ray, Cameron C Wick, Kristine Blackham, David Stepnick, Pierre Lavertu, Chad A Zender
OBJECTIVES/HYPOTHESIS: To illustrate complex interdisciplinary decision making and the utility of modern endovascular techniques in the management of patients with carotid blowout syndrome (CBS). STUDY DESIGNS: Retrospective chart review. METHODS: Patients treated with endovascular strategies and/or surgical modalities were included. Control of hemorrhage, neurological, and survival outcomes were studied. RESULTS: Between 2004 and 2014, 33 patients had 38 hemorrhagic events related to head and neck cancer that were managed with endovascular means...
November 30, 2016: Laryngoscope
https://www.readbyqxmd.com/read/27898402/recent-update-on-carotid-endarterectomy-versus-carotid-artery-stenting
#6
Raywat Noiphithak, Anusak Liengudom
Carotid artery stenosis (CS) is a major cause of ischemic stroke. Treatment of CS consists of best medical treatment and carotid revascularization (CR), including carotid endarterectomy (CEA) and carotid artery stenting (CAS). Both CR techniques have their own procedural risks. Therefore, selection of the appropriate treatment for patients with CS is relatively complicated. Many studies and guidelines have reported the efficacy of each treatment for both symptomatic and asymptomatic patients. However, the results are still controversial, especially concerning the efficacy and safety of CEA and CAS...
November 30, 2016: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/27896414/closure-devices-for-iatrogenic-thoraco-cervical-vascular-injuries
#7
Gregory C Makris, Rafiuddin Patel, Mark Little, Carina Tyrrell, James Sutcliffe, Kader Allouni, Mark Bratby, Susan Anthony, Raman Uberoi
INTRODUCTION: The unintentional arterial placement of a central venous line can have catastrophic complications. The purpose of this systematic review is to assess and analyse the available evidence regarding the use of the various vascular closure devices (VCDs) for the management of iatrogenic thoraco-cervical arterial injuries (ITCAI). METHODS: A systematic review was performed according to PRISMA guidelines. RESULTS: Thirty-two relevant case series and case reports were identified with a total of 69 patients having being studied...
November 28, 2016: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/27891422/panvascular-disease-in-familial-hypercholesterolaemia-treated-with-endovascular-simultaneous-bilateral-carotid-stenting
#8
Anand Alurkar, Lakshmi Sudha Prasanna Karanam, Shripal Shah, Pandurang Mare
Familial Hypercholesterolaemia (FH) is a monogenic autosomal dominant disorder affecting 1 in 500 individuals. We report a case of 32-year-old female with FH, previously not on any treatment, who presented with recurrent bilateral Middle Cerebral Artery (MCA) territory strokes and dyspnoea on exertion due to severe panvascualar disease involving descending aorta, innominate, subclavian, common carotid, internal carotid and coronary vessels. Her complete clinical work up was done and was started on lipid lowering drug treatment and low calorie diet...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27890834/eagle-syndrome-presenting-after-blunt-trauma
#9
Ashley Mann, Scott Kujath, Mark L Friedell, Scott Hardouin, Chalmers Wood, Robert Carter, Karl Stark
As classically described, Eagle syndrome is an entity where patients develop pain or neurologic manifestations arising from an elongated styloid process and/or an ossified stylohyoid ligament irritating or compressing adjacent cranial nerves or the carotid arteries. Over the past few years, there have been reports of actual injury to the internal carotid artery with dissection, occlusion and strokes. We present three cases identified after blunt trauma-one due to carotid compression and two due to actual injury to the internal carotid artery...
November 24, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27881699/multicenter-experience-of-surgical-explantation-of-carotid-stents-for-recurrent-stenosis
#10
Jesse A Columbo, John C McCallum, Philip P Goodney, Thomas C Bower, Marc L Schermerhorn, Richard J Powell, Randall R DeMartino
OBJECTIVE: A significant cohort of patients who have undergone carotid artery stenting (CAS) will have in-stent restenosis (ISR). The optimal management of symptomatic or severe ISR remains poorly defined. The purpose of this study was to describe the indications, treatment, and mid- to long-term outcomes of patients undergoing CAS explantation for ISR. METHODS: All patients undergoing internal carotid artery stent explantation with carotid artery reconstruction at Mayo Clinic Rochester, Dartmouth-Hitchcock Medical Center, and Beth-Israel Deaconess Medical Center from 2003 to 2013 were retrospectively reviewed...
November 22, 2016: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27881689/acute-type-a-aortic-dissection-treated-using-a-tubular-stent-graft-in-the-ascending-aorta-and-a-multibranched-stent-graft-in-the-aortic-arch
#11
Tilo Kölbel, Christian Detter, Sebastian W Carpenter, Fiona Rohlffs, Yskert von Kodolitsch, Sabine Wipper, Herrmann Reichenspurner, E Sebastian Debus, Nikolaos Tsilimparis
PURPOSE: To describe the combined use of a tubular stent-graft for the ascending aorta and an inner-branched arch stent-graft for patients with acute type A aortic dissection. TECHNIQUE: The technique to deploy these modular, custom-made stent-grafts is demonstrated in 2 patients with acute DeBakey type I aortic dissections and significant comorbidities precluding open surgery. Both emergent procedures were made possible by the availability of suitable devices manufactured for elective repair in other patients...
November 23, 2016: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/27881360/an-observational-registry-of-carotid-endarterectomy-and-carotid-artery-stenting-in-brazil-study-protocol
#12
Edwaldo Edner Joviliano, Winston Bonetti Yoshida, Marcone Lima Sobreira, Regina Moura, Ana Terezinha Guillaumon, Selma Regina De Oliveira Raymundo, Daniel Gustavo Miquelin, Ludvig Hafner, Marcelo Jose Almeida
BACKGROUND: Carotid artery stenting (CAS) and carotid endarterectomy (CEA) are alternative strategies for stroke prevention in patients with atherosclerotic carotid disease. CEA has been considered the first-line treatment for carotid stenosis worldwide, and the safety and efficacy of CAS compared to CEA remains in question. OBJECTIVE: The purpose of this study is to compare the practice and outcomes of CAS and CEA in a real-world setting within public university hospitals in Brazil...
November 23, 2016: JMIR Research Protocols
https://www.readbyqxmd.com/read/27876658/stenting-for-carotid-web-a-case-report
#13
R Martínez-Pérez, S P Lownie, S Pandey, M R Boulton
BACKGROUND: The carotid web is an intraluminal shelf-like projection arising from the posterior wall of the carotid bifurcation, and is an uncommon etiology of ischemic strokes. Our objective is to describe the feasibility of endovascular stenting to treat this condition CASE REPORT: In a 47-year-old female with a sudden occlusion of her right middle cerebral artery. CT angiogram and digital subtraction angiography showed the presence of a carotid web in the ipsilateral carotid bifurcation...
November 19, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27876518/an-update-on-the-role-of-proximal-occlusion-devices-in-carotid-artery-stenting
#14
Daniel S Kassavin, Daniel G Clair
Carotid artery stenting performed with distal embolic protection devices continues to show elevated rates of periprocedural stroke, in particular with high-risk groups. This article discusses the factors associated with protection devices that may contribute to this complication, performs a literature review to assess outcomes of carotid stenting with proximal occlusion devices, and assesses the role of proximal occlusion devices in the management of patients with carotid artery stenosis.
November 19, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27870819/angiographic-characteristics-of-pseudo-occlusion-of-the-internal-carotid-artery-before-and-after-stenting
#15
Yoshikazu Matsuda, Tomoaki Terada, Hideo Okada, Osamu Masuo, Kousuke Ohshima, Mitsuharu Tsuura, Naoyuki Nakao
BACKGROUND: Various definitions of pseudo-occlusion and clinical outcomes after various treatments have been reported, but reports discussing the stenotic characteristics of pseudo-occlusion are rare. OBJECTIVE: To analyze the angiographic characteristics of pseudo-occlusion of the internal carotid artery (ICA) before and after carotid artery stenting (CAS). METHODS: We retrospectively reviewed the angiographic characteristics of 56 patients with pseudo-occlusion of the ICA treated with CAS...
December 2016: Neurosurgery
https://www.readbyqxmd.com/read/27869549/carotid-artery-stenting-with-double-cerebral-embolic-protection-in-asymptomatic-patients-a-diffusion-weighted-mri-controlled-study
#16
Ertan Vuruskan, Erhan Saracoglu, Ugur Ergun, Fatih Poyraz, İrfan Veysel Duzen
BACKGROUND: The aim of this study was to compare the simultaneous double-protection method (proximal balloon plus distal filter) with distal-filter protection or proximal-balloon protection alone in asymptomatic patients during carotid artery stenting. PATIENTS AND METHODS: 119 consecutive patients were investigated for carotid artery stentings in the extracranial internal carotid artery with the use of distal filters (n = 41, 34.4 %), proximal balloon (MoMa) protection (n = 40, 33...
November 24, 2016: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/27869217/magnesium-alloy-covered-stent-for-treatment-of-a-lateral-aneurysm-model-in-rabbit-common-carotid-artery-an-in-vivo-study
#17
Wu Wang, Yong-Li Wang, Mo Chen, Liang Chen, Jian Zhang, Yong-Dong Li, Ming-Hua Li, Guang-Yin Yuan
Magnesium alloy covered stents have rarely been used in the common carotid artery (CCA). We evaluated the long-term efficacy of magnesium alloy covered stents in a lateral aneurysm model in rabbit CCA. Magnesium alloy covered stents (group A, n = 7) or Willis covered stents (group B, n = 5) were inserted in 12 New Zealand White rabbits and they were followed up for 12 months. The long-term feasibility for aneurysm occlusion was studied through angiograms; the changes in vessel area and lumen area were assessed with IVUS...
November 21, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27865698/immunohistochemical-analysis-of-debris-captured-by-filter-type-distal-embolic-protection-devices-for-carotid-artery-stenting
#18
Yukinao Kambayashi, Ichiro Yuki, Toshihiro Ishibashi, Ayako Ikemura, Takashi Umezawa, Masafumi Suzuki, Issei Kan, Hiroyuki Takao, Yuichi Murayama
BACKGROUND: Little is known about the micro-debris captured in filter-type distal embolic protection devices (EPD) used for carotid stenting (CAS). This study aimed to determine the histological and immunohistochemical characteristics of such debris by using a new liquid-based cytology (LBC) technique. METHODS: Fifteen patients who underwent CAS using a filter-type distal EPD (FilterWire EZ; Boston Scientific, Marlborough, MA, USA) were included in the study. After gross inspection of each recovered filter device, micro-debris were collected using a new LBC technique (SurePath; TriPath Imaging, Inc...
November 17, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27865641/canadian-cardiovascular-society-guidelines-on-perioperative-cardiac-risk-assessment-and-management-for-patients-who-undergo-noncardiac-surgery
#19
Emmanuelle Duceppe, Joel Parlow, Paul MacDonald, Kristin Lyons, Michael McMullen, Sadeesh Srinathan, Michelle Graham, Vikas Tandon, Kim Styles, Amal Bessissow, Daniel I Sessler, Gregory Bryson, P J Devereaux
The Canadian Cardiovascular Society Guidelines Committee and key Canadian opinion leaders believed there was a need for up to date guidelines that used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system of evidence assessment for patients who undergo noncardiac surgery. Strong recommendations included: 1) measuring brain natriuretic peptide (BNP) or N-terminal fragment of proBNP (NT-proBNP) before surgery to enhance perioperative cardiac risk estimation in patients who are 65 years of age or older, are 45-64 years of age with significant cardiovascular disease, or have a Revised Cardiac Risk Index score ≥ 1; 2) against performing preoperative resting echocardiography, coronary computed tomography angiography, exercise or cardiopulmonary exercise testing, or pharmacological stress echocardiography or radionuclide imaging to enhance perioperative cardiac risk estimation; 3) against the initiation or continuation of acetylsalicylic acid for the prevention of perioperative cardiac events, except in patients with a recent coronary artery stent or who will undergo carotid endarterectomy; 4) against α2 agonist or β-blocker initiation within 24 hours before surgery; 5) withholding angiotensin-converting enzyme inhibitor and angiotensin II receptor blocker starting 24 hours before surgery; 6) facilitating smoking cessation before surgery; 7) measuring daily troponin for 48 to 72 hours after surgery in patients with an elevated NT-proBNP/BNP measurement before surgery or if there is no NT-proBNP/BNP measurement before surgery, in those who have a Revised Cardiac Risk Index score ≥1, age 45-64 years with significant cardiovascular disease, or age 65 years or older; and 8) initiating of long-term acetylsalicylic acid and statin therapy in patients who suffer myocardial injury/infarction after surgery...
October 4, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/27865168/peristrut-microhemorrhages-a-possible-cause-of-in-stent-neoatherosclerosis
#20
Zaven Terzian, T Christian Gasser, Francis Blackwell, Fabien Hyafil, Liliane Louedec, Catherine Deschildre, Walid Ghodbane, Richard Dorent, Antonino Nicoletti, Marion Morvan, Mohammed Nejjari, Laurent Feldman, Graciela Pavon-Djavid, Jean-Baptiste Michel
BACKGROUND: In-stent neoatherosclerosis is characterized by the delayed appearance of markers of atheroma in the subintima, but the pathophysiology underlying this new disease entity remains unclear. METHODS AND RESULTS: We collected 20 human coronary artery stents by removal from explanted hearts. The mean duration of stent implantation was 34 months. In all samples, neoatherosclerosis was detected, particularly in peristrut areas. It consisted of foam cells and cholesterol clefts, with or without calcification, associated with neovascularization...
August 29, 2016: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
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