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https://www.readbyqxmd.com/read/28727356/-management-of-carotid-artery-stenosis
#1
Francesco Puccinelli, Marco Roffi, Nicolas Murith, Roman Sztajzel
Carotid artery atherosclerosis remains one of the major causes of stroke. The efficacy of carotid artery recanalization has already been established and is considered significant for symptomatic stenosis >70% and moderate for stenosis between 50-69 %. Regarding asymptomatic stenosis, carotid artery recanalization should be reserved for carefully selected patients with a stenosis between 70-90 % and an estimated procedural risk at less than 3 %. Two therapeutic options are currently available : angioplasty with stent placement and endarterectomy...
April 26, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28721332/to-stent-or-not-to-stent-a-tale-of-two-occlusions
#2
Ali S Haider, Lyndon K Lee, Tijani Osumah, Saira Alli, Umair Khan, Steven Vayalumkal, Aida Kafai Golahmadi, Richa Thakur, Phu Nguyen, Kennith F Layton
Stenting and balloon angioplasty, along with mechanical thrombectomy, have gained notability as adjunctive treatment options to intravenous tissue plasminogen activator (IV-tPA) for tandem internal carotid artery (ICA) and middle cerebral artery (MCA) occlusions (TIM occlusions). Acute ischemic strokes (AISs) secondary to TIM occlusions are associated with poor patient outcomes primarily due to low recanalization rates following intravenous thrombolysis, consequently prompting the need for more invasive recanalization efforts...
June 17, 2017: Curēus
https://www.readbyqxmd.com/read/28716303/early-results-of-endovascular-treatment-of-patients-with-bilateral-stenoses-of-the-internal-carotid-arteries-using-proximal-protection-systems-at-30-day-follow-up
#3
Paweł Latacz, Marian Simka, Tadeusz Popiela, Marek Kazibudzki, Tomasz Mrowiecki
BACKGROUND: Although surgical endarterectomy remains the treatment of choice for carotid artery stenosis, carotid artery stenting (CAS) with use of proximal protection systems (PPS) plays an very important role as alternative treatment modality, especially in patients with critical, symptomatic lesions. This study was single-centre study to evaluate the technical and clinical success of proximal protection devices as the first choice for embolic protection in symptomatic and asymptomatic carotid stenosis in patients with bilateral, advanced lesions of carotid arteries (bilateral stenoses or stenosis and occlusion)...
July 8, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/28712899/iatrogenic-ascending-pharyngeal-artery-injury-by-pre-dilation-balloon-inflation-during-carotid-artery-stenting-with-flow-reversal
#4
Junpei Koge, Tomonori Iwata, Shigehisa Mizuta, Yukihiko Nakamura, Shun-Ichi Matsumoto, Takeshi Yamada
BACKGROUND: The ascending pharyngeal artery (APA) may rarely arise from the common carotid artery bifurcation. We herein report an injury to the APA as an unusual complication of pre-dilation balloon inflation during carotid artery stenting (CAS) with flow reversal. CASE DESCRIPTION: A 73-year-old man presented with symptomatic severe left cervical internal carotid artery (ICA) stenosis. The left APA arose from the common carotid artery bifurcation. We performed CAS with flow reversal to decrease the risk of distal embolization...
July 13, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28710049/trans-anterior-communicating-artery-primary-stenting-in-acute-tandem-middle-cerebral-artery-internal-carotid-artery-occlusion-due-to-thoracic-aortic-stent-graft
#5
Sergio Nappini, Nicola Limbucci, Giuseppe Leone, Antonio Laiso, Andrea Wlderk, Salvatore Mangiafico
No abstract text is available yet for this article.
July 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28710044/treatment-strategies-of-subarachnoid-hemorrhage-from-bilateral-vertebral-artery-dissection-a-case-report-and-literature-review-focusing-on-availability-of-stent-placement
#6
Yasuo Murai, Fumihiro Matano, Shoji Yokobori, Hidetaka Onda, Hiroyuki Yokota, Akio Morita
BACKGROUND: Bilateral vertebral artery dissection (VAD) may result in subarachnoid hemorrhage (SAH). However, a variety of factors contribute to the difficulties with treating SAH. We report a case of bilateral VAD with SAH, as well as a literature review. CASE DESCRIPTION: A 32-year-old woman developed headache. Computed tomography (CT) demonstrated diffuse SAH, and 3-dimensional CT indicated bilateral VAD. Her left vertebral artery was severely stenosed and the basilar artery was retrogradely flowed via the posterior communicating artery...
July 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28709707/endovascular-treatment-of-acute-ischemic-stroke-with-eric-device
#7
Laurent Pierot, Jean-Yves Gauvrit, Vincent Costalat, Michel Piotin, Charbel Mounayer, Denis Herbreteau, Sophie Gallas, René Anxionnat, Hubert Desal
BACKGROUND AND PURPOSE: After 6 positive randomized trials, mechanical thrombectomy with stent-retriever is now recommended as a first-line treatment for acute ischemic stroke (AIS). The ERIC device is a device with several interlinked cage-like spheres fixed on a pusher wire. Neurothrombectomy France (NTF) is a registry conducted in France to analyze the results of mechanical thrombectomy. In order to analyze its performances, the subgroup of patients treated with the ERIC device was analyzed...
July 11, 2017: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/28708869/long-term-efficacy-and-safety-of-carotid-artery-stenting-versus-endarterectomy-a-meta-analysis-of-randomized-controlled-trials
#8
Yang Li, Jing-Jing Yang, Su-Hui Zhu, Biao Xu, Lian Wang
BACKGROUND: Many recent trials have investigated the long-term efficacy and safety of endarterectomy versus stenting in treating patients with carotid artery stenosis. We aimed to determine the long-term comparative efficacy and safety of both procedures by pooling this evidence in a meta-analysis. METHODS: We searched PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials for studies published until May 6, 2016. Randomized controlled trials, which reported outcomes of interest with a median follow-up of at least 4-year, were included...
2017: PloS One
https://www.readbyqxmd.com/read/28704454/indocyanine-green-kinetics-with-near-infrared-spectroscopy-predicts-cerebral-hyperperfusion-syndrome-after-carotid-artery-stenting
#9
Ichiro Nakagawa, Hun Soo Park, Shohei Yokoyama, Shuichi Yamada, Yasushi Motoyama, Young Su Park, Takeshi Wada, Kimihiko Kichikawa, Hiroyuki Nakase
BACKGROUND: Cerebral hyperperfusion syndrome (HPS) is a potentially life-threatening complication following carotid artery stenting (CAS) and carotid endoarterectomy (CEA). Early prediction and treatment of patients at risk for HPS are required in patients undergoing CAS because HPS occurs significantly earlier after CAS than CEA. Near-infrared spectroscopy (NIRS) is often used for monitoring, and indocyanine green (ICG) kinetics by NIRS (ICG-NIRS) can detect reductions in cerebral perfusion in patients with acute stroke...
2017: PloS One
https://www.readbyqxmd.com/read/28702117/balloon-angioplasty-for-intracranial-atherosclerotic-disease-a-multicenter-study
#10
Lakshmi Sudha Prasanna Karanam, Mukesh Sharma, Anand Alurkar, Sridhar Reddy Baddam, Vijaya Pamidimukkala, Raghavasarma Polavarapu
AIM: To evaluate the role and efficacy of the balloon angioplasty in intracranial atherosclerotic disease (ICAD) in patients who presented with acute stroke due to vessel occlusion and in patients with symptomatic disease despite optimum medical management. METHODS: From 2013 to 2016, a total of 39 patients (24 males and 15 females with a mean age of 64.5 years) underwent balloon angioplasty over a period of 2 years and 8 months in three different institutions in India...
June 2017: Journal of Vascular and Interventional Neurology
https://www.readbyqxmd.com/read/28701298/carotid-stenting-for-unilateral-stenosis-can-increase-contralateral-hemispheric-cerebral-blood-flow
#11
Akiyo Sadato, Shingo Maeda, Motoharu Hayakawa, Kazuhide Adachi, Hiroshi Toyama, Ichiro Nakahara, Yuichi Hirose
BACKGROUND: The revascularization of carotid stenosis can increase ipsilateral cerebral blood flow (CBF). Occasionally, elevated CBF is also evident on the contralateral side, but this phenomenon is poorly understood. OBJECTIVE: To analyze retrospectively the relationship between a contralateral CBF increase and several clinical and radiologic features. MATERIALS AND METHODS: We retrospectively analyzed 40 patients with unilateral cervical carotid stenosis treated by carotid artery stenting (CAS)...
July 12, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28700965/inhibitory-effects-of-asp6537-a-selective-cyclooxygenase-1-inhibitor-on-thrombosis-and-neointima-formation-in-rats
#12
Chinatsu Sakata, Tomihisa Kawasaki, Yoshiyuki Iwatsuki, Yumiko Moritani, Yoshiaki Morita, Hideaki Hara
INTRODUCTION: Percutaneous coronary interventions (PCIs), such as balloon angioplasty and stent placement, are effective in the treatment of coronary artery disease. PCI has drawbacks, however, including acute thrombosis after the procedure and restenosis of the vascular lumen due to abnormal neointimal hyperplasia. ASP6537 is a selective COX-1 inhibitor that has been investigated as a possible candidate for clinical development as an antiplatelet agent. In the present study, we evaluated the in vivo antithrombotic effect of ASP6537 and its effect on neointima formation after balloon angioplasty...
July 2, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28697713/an-update-of-the-italian-stroke-organization-stroke-prevention-awareness-diffusion-group-guidelines-on-carotid-endarterectomy-and-stenting-a-personalized-medicine-approach
#13
Gaetano Lanza, Carlo Setacci, Stefano Ricci, Patrizio Castelli, Alberto Cremonesi, Jessica Lanza, Claudio Novali, Carlo Pratesi, Paola Santalucia, Francesco Speziale, Augusto Zaninelli, Gian Franco Gensini
Although proof-based medicine has generated much valid evidence for the drawing up of guidelines and recommendations for best clinical practice in symptomatic and asymptomatic carotid stenosis, whether and when it is better to employ endarterectomy or stenting as the intervention of choice still remain matters of debate. Moreover, guidelines have been targeted up to now to the 'representative' patient, as resulting from the statistical analyses of the studies conducted on the safety and efficacy of both interventions as well as on medical therapy alone...
July 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28693048/the-use-of-branched-endografts-for-the-aortic-arch-in-the-endovascular-era
#14
Rami O Tadros, Scott R Safir, Peter L Faries, Daniel K Han, Rajiv K Chander, Cherrie Z Abraham, Michael L Marin, Allan S Stewart
The endovascular realm has steadily increased its footing in the treatment of the aorta and all of its territories since the foundational case in 1990 by Parodi. The aortic arch, however, continues to be one of the last bastions for treatment via open surgery, which remains the gold standard. Significant comorbidity and prior cardiac surgery prevent open surgery from being the only preferred option, allowing novel endovascular procedures to be considered. Since 1999, more advanced endovascular systems have been created by companies such as Cook Medical, Bolton Medical, Medtronic, Endospan, Gore Medical, and, recently, Kawasumi...
July 11, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28691137/effective-use-of-balloon-guide-catheters-in-reducing-incidence-of-mechanical-thrombectomy-related-distal-embolization
#15
Dong Hoon Lee, Jae Hoon Sung, Sang Uk Kim, Ho Jun Yi, Jae Taek Hong, Sang Won Lee
BACKGROUND AND PURPOSE: The clinical benefit of endovascular stroke therapy has been demonstrated in several prospective randomized trials. However, in a relevant percentage of patients, mechanical thrombectomy bears the risk of causing new infarction in initially unaffected vascular territories through thrombus fragmentation and migration of clot debris. The goal of this study was to evaluate the use of the balloon guide catheter (BGC) to effectively achieve flow arrest and thrombus aspiration during the intervention to avoid distal embolization...
July 9, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28689955/flow-diverting-stent-in-the-treatment-of-cervical-carotid-dissection-and-pseudoaneurysm-review-of-literature-and-case-report
#16
REVIEW
Anna Paula Weinhardt Baptista-Sincos, Aline Bigatão Simplício, Igor Rafael Sincos, Alex Leaderman, Fernando Saliture Neto, Adjaldes Moraes, Ricardo Aun
BACKGROUND: The endovascular technique has been recommended over the past few years to extracranial carotid dissection and pseudoaneurysm with promising results, specially after medical therapy failure. Flow-diverting stents are an alternative for complex cases. These stents have proven to be effective treatment devices for intracranial aneurysms. OBJECTIVE: To find out all cases of flow-diverting stents in the treatment of extracranial carotid dissection with or without pseudoaneurysm and compare to our case report...
July 6, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28689951/spot-stenting-of-supra-aortic-branch-vessels-for-residual-type-a-dissection
#17
Ciro Ferrer, Raffaele Grande, Luigi Venturini, Valerio Scarano Catanzaro, Gabriele Maritati, Luca di Marzo
of this report is to describe the exclusion of the false lumen in a residual type A aortic dissection (TAAD) by the deployment of two covered stents: one in the right common carotid artery (RCCA) and one in the left subclavian artery (LSA). A 77-year-old female, already treated with ascending aorta replacement for acute TAAD, was referred to our center for a 97-mm post-dissection arch aneurysm. A computed tomography angiography (CTA) showed false lumen patency by reperfusion from secondary tears located at level of RCCA and LSA...
July 6, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28688714/restenosis-predictors-after-carotid-angioplasty-and-stenting-and-its-influence-on-procedure-durability-single-center-experience
#18
Ossama Y Mansour, Abdelrahman Ibrahim, Mostafa Talaat
BACKGROUND: This article reports our experience regarding in-stent restenosis in the carotid arteries with special focus was given to angiographic morphology and clinical predictors of in-stent restenosis. METHODS: Between July 2008 and August 2011, 245 carotid angioplasty and stenting procedures were performed in 243 patients (172 men and 71 women). Stenting for de novo stenoses was performed in 214 (87.3%) carotid arteries, and 31 (12.7%) vessels were treated because of postsurgical restenosis...
July 5, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28688468/evaluation-and-management-of-atherosclerotic-carotid-stenosis
#19
REVIEW
James F Meschia, James P Klaas, Robert D Brown, Thomas G Brott
Medical therapies for the prevention of stroke have advanced considerably in the past several years. There can also be a role for mechanical restoration of the lumen by endarterectomy or stenting in selected patients with high-grade atherosclerotic stenosis of the extracranial carotid artery. Endarterectomy is generally recommended for patients with high-grade symptomatic carotid stenosis. Stenting is considered an option for patients at high risk of complications with endarterectomy. Whether revascularization is better than contemporary medical therapy for asymptomatic extracranial carotid stenosis is a subject of several ongoing randomized clinical trials in the United States and internationally...
July 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28687500/analysis-of-hemodynamic-changes-in-early-stage-after-carotid-stenting-by-transcranial-doppler-a-preliminary-study
#20
Ziguang Yan, Min Yang, Guochen Niu, Yinghua Zou
BACKGROUND: Cerebral hyperperfusion syndrome (CHS) or hemodynamic instability(HI), caused by the hemodynamic changes, often occur within 6 hours after carotid artery stenting (CAS) The post-procedure cerebral hemodynamic change in the early phase, less than 6 hours after CAS, is largely unknown. In this study we evaluated the cerebral hemodynamic changes in patients after CAS using transcranial Doppler (TCD). METHODS: From January, 2013 to July, 2014, medical records of 61 patients underwent CAS were reviewed retrospectively...
July 4, 2017: Annals of Vascular Surgery
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