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carotid artery stent

Chi-Hung Liu, Tsong-Hai Lee, Pi-Yueh Chang, Chien-Hung Chang, Hsiu-Chuan Wu, Ting-Yu Chang, Kuo-Lun Huang, Chih-Kuang Cheng, Yeu-Jhy Chang
BACKGROUND: We hypothesized the inflammatory markers (IM) could be independent predictors of carotid stenosis progression (CSP) after carotid artery stenting (CAS). METHODS: Between 2010 and 2012, 122 patients undergoing cervicocranial revascularization in our hospital were prospectively recruited. Patients undergoing revascularizations other than CAS were excluded. Carotid duplex ultrasonography was performed before and at 1 week, 6 months (6M), 1 year, and 2 years after CAS...
March 19, 2018: Current Neurovascular Research
Seung Woon Rha
No abstract text is available yet for this article.
March 2018: Korean Circulation Journal
Hee Jin Kwon, Jae Hyeong Park, Jae Hwan Lee, Hye Seon Jeong, Hee Jung Song, Jei Kim, Mijoo Kim, In Sun Kwon, In Whan Seong
BACKGROUND AND OBJECTIVES: Neurologic intolerance (NI) is defined as the occurrence of neurological symptoms during carotid artery stenting (CAS). Because NI is inevitable problem, it may be helpful to anticipate its occurrence. So, we studied factors associated with NI during proximal protected CAS. METHODS: We retrospectively analyzed all consecutive patients underwent proximal protected CAS from August 2012 to January 2017. RESULTS: We included total 123 patients (109 males, 72±8 years old)...
March 2018: Korean Circulation Journal
Todd R Vogel, Robin L Kruse, Ryan J Kim, Viktor Y Dombrovskiy
BACKGROUND: Race has been associated with inferior outcomes after multiple procedures, but the association of socioeconomic status with procedures for cerebrovascular disease is not well established. MATERIALS AND METHODS: Elective carotid artery stenting (CAS) and carotid endarterectomy (CEA) procedures were identified in the National Inpatient Sample, 2012 to 2014. Median household income was estimated from patient ZIP codes. Chi-square and multivariable logistic regression analysis evaluated outcomes, accounting for age, race, gender, comorbidities, procedure, income, insurance, and hospital characteristics...
January 1, 2018: Vascular and Endovascular Surgery
Masanori Tsujimoto, Yukiko Enomoto, Masafumi Miyai, Yusuke Egashira, Toru Iwama
Purpose To determine the best platelet function test for in-stent tissue protrusion following carotid artery stenting (CAS). Methods Patients who underwent CAS were recruited prospectively in this observational study. Combination of aspirin 100 mg/day and clopidogrel 75 mg/day was administered for a minimum of 7 days prior to procedure. Platelet aggregation was measured by light transmittance aggregometry (LTA) following stimulation by adenosine diphosphate (ADP), collagen, and thrombin receptor activating peptide (TRAP) and by the point of care assay, VerifyNow which measures aspirin and thienopyridine reaction units...
January 1, 2018: Journal of International Medical Research
Lin Yang, Jianlin Liu, Guangyu Qi, Yanzi Li, Yamin Liu
This study aims to investigate the complication and middle-term outcome of carotid endarterectomy (CEA) and carotid artery stenting (CAS) in Chinese patients, which was a retrospective case-control study and perioperative complications and 2-year end points were analyzed. Follow-up was done by a certified doctor, and restenosis was detected by ultrasound. Operation success rate were 100% in two groups. CAS showed the higher incidence rate of all stroke/TIA at 30days post-procedure (7.89% VS 1.85%, P = 0...
March 16, 2018: Scientific Reports
Andreas Kastrup, Freimuth Brunner, Helmut Hildebrandt, Christian Roth, Michael Winterhalter, Panagiotis Papanagiotou
BACKGROUND AND PURPOSE: In patients with large vessel occlusions, endovascular treatment (ET) has been shown to be superior to intravenous thrombolysis (IVT) in recent trials. However, the effectiveness of ET in elderly patients is uncertain. METHODS: Using our stroke database, we compared the rates of good outcome (modified Rankin scale (mRS) ≤2), excellent outcome (mRS 0-1), poor outcome (mRS 5-6) at discharge, in-hospital death, infarct size, and symptomatic intracranial hemorrhage (SICH) in patients aged ≥80 years with distal intracranial carotid artery, M1 and M2 occlusions during two time periods...
March 16, 2018: Journal of Neurointerventional Surgery
Yoshitaka Shimizu, Takahito Okazaki, Tomoaki Hamana, Masahiro Irifune
Treatment of pseudoaneurysms in the internal carotid artery (ICA) is associated with a high risk of cerebral infarction; therefore, vessel ligation for hemostasis must be avoided. A 66-year-old man had intraoral hemorrhaging. At the time of the initial examination, computed tomography angiography showed jaw plate displacement near the ICA. A more detailed image was obtained using digital-subtraction angiography. After evaluation of the image, a pseudoaneurysm was diagnosed. Six days later, there were concerns about aspiration and airway obstruction; therefore, tracheostomy was performed...
February 20, 2018: Journal of Oral and Maxillofacial Surgery
Chuanjie Wu, Chuanhui Li, Wenbo Zhao, Nanchang Xie, Feng Yan, Yajun Lian, Li Zhou, Xiaoya Xu, Yong Liang, Lu Wang, Ming Ren, Sijie Li, Xuan Cheng, Lu Zhang, Qingfeng Ma, Haiqing Song, Ran Meng, Xunming Ji
OBJECTIVES: To investigate whether the plasma level of trimethylamine N -oxide (TMAO), a proatherosclerotic intestinal microbiota metabolite, can be a predictor of ischemic brain injury secondary to carotid artery stenting (CAS). METHODS: In this multicenter, prospective cohort study, we enrolled patients with severe carotid artery stenosis (>70%) who were prepared for CAS. Plasma TMAO level was measured within 3 days before CAS, and MRI was performed 1 to 3 days after CAS...
March 14, 2018: Neurology
Christian Foerch
No abstract text is available yet for this article.
March 14, 2018: Neurology
Michael Young, Greg Imbarrato, Ajeet Gordhan
A 74-year-old male developed cervical carotid artery psuedoaneurysm 8 months after carotid endarterectomy. The patient was successfully managed with dual implantation of flow-diverter and conventional carotid stent. Flow-diverter was placed across the neck of pseudoaneurysm to provide flow diversion while carotid stent was implanted within the lumen of the expanded flow-diverter to approximate and hold the flow diverter proximal and distal to the pseudoaneurysm. Follow-up ultrasonography revealed complete resolution of the pseudoaneurysm...
March 2018: Neurointervention
Giulio Illuminati, Giulia Pizzardi, Rocco Pasqua, Francesca Frezzotti, Piergaspare Palumbo, Francesco Macrina, Francesco Calio
BACKGROUND: Tandem stenoses of the internal carotid artery (ICA) and proximal, ipsilateral common carotid artery (CCA) or innominate artery can be treated with a hybrid approach, combining conventional carotid endarterectomy (CEA) and retrograde stenting of the proximal stenosis, through surgical exposure of the carotid bifurcation. The purpose of this study was to evaluate the results of combining eversion CEA with retrograde CCA/innominate artery stenting. MATERIAL AND METHODS: From January 2015 to July 2017, 7 patients, 6 men of a mean age of 72 years (range 59-83 years) underwent simultaneous, retrograde stenting of the proximal CCA/innominate artery and an eversion CEA of the ipsilateral ICA, through surgical exposure of the carotid bifurcation, for severe tandem stenoses...
March 10, 2018: International Journal of Surgery
Nupoor Narula, Daniella Kadian-Dodov, Jeffrey W Olin
Fibromuscular dyplasia (FMD) is an under-recognized non-atherosclerotic, non-inflammatory arteriopathy that occurs most commonly in middle-aged women, but may affect individuals of all age groups. FMD may result in stenosis, aneurysm, dissection, occlusion, or arterial tortuosity. Recently published data demonstrated a genetic association of FMD with a variant in the phosphatase and actin regulator 1 gene (PHACTR1), substantiating that the pathogenesis of this condition has genetic contribution. The renal and extracranial carotid and vertebral arteries are most often involved, although any arterial bed may be affected...
March 10, 2018: Progress in Cardiovascular Diseases
Robert D Safian
The use of double layer (covered) stents during carotid artery stenting (CAS) appears to be safe; attenuation of plaque prolapse and distal embolization is reasonable but unproven. Double layer stents are commercially available in Europe but not in the United States; similar benefits might be obtained by implanting two self-expanding stents, to decrease the effective free cell area. Embolic protection devices (EPDs) are recommended in all CAS patients; the use of double layer stents does not eliminate the need for EPDs...
March 1, 2018: Catheterization and Cardiovascular Interventions
Kouichi Misaki, Naoyuki Uchiyama, Anri Inaki, Seigo Kinuya, Iku Nambu, Tomoya Kamide, Masanao Mohri, Yasuhiko Hayashi, Mitsutoshi Nakada
BACKGROUND AND PURPOSE: Hemodynamic impairments are considered risk factors of cerebral hyperperfusion after carotid artery stenting (CAS); measurement by SPECT using a subjective ROI method lacks consistency and reproducibility. MATERIALS AND METHODS: The present study compared objective perfusion analysis (stereotactic extraction estimation [SEE] method) with the ROI method for preoperative SPECT to predict the hyperperfusion phenomenon (HPP) after CAS. Preoperative resting asymmetry index (CBF ratio from the affected to unaffected hemisphere) and cerebrovascular reactivity (CVR) to acetazolamide were measured by N-isopropyl-p-[123 I]-iodoamphetamine SPECT using the SEE and ROI method in 84 patients...
March 7, 2018: Journal of Neuroradiology. Journal de Neuroradiologie
Mikiya Beppu, Yohei Mineharu, Hirotoshi Imamura, Hidemitsu Adachi, Chiaki Sakai, Shoichi Tani, Koichi Arimura, So Tokunaga, Nobuyuki Sakai
BACKGROUND AND PURPOSE: Although in-stent protrusion is a potential risk factor of thromboembolism following carotid artery stenting, the correlation between in-stent protrusion and postoperative ipsilateral stroke has not been well examined. MATERIALS AND METHODS: We retrospectively reviewed 342 consecutive carotid artery lesions in 319 patients who underwent carotid artery stenting between April 2008 and April 2015. After excluding cases with carotid artery dissection and acute occlusion, 301 lesions in total of 277 patients were included in the analysis...
March 7, 2018: Journal of Neuroradiology. Journal de Neuroradiologie
Mitchell P Wilson, Mohammad H Murad, Timo Krings, Vitor M Pereira, Cian O'Kelly, Jeremy Rempel, Christopher A Hilditch, Waleed Brinjikji
BACKGROUND: Optimal technical approaches of large-vessel anterior circulation acute ischemic strokes with concomitant extracranial internal carotid artery tandem occlusions is controversial. PURPOSE: This systematic review and meta-analysis evaluates: the overall outcomes of patients with tandem occlusions treated with second-generation mechanical thrombectomy devices; differences in outcomes of extracranial versus intracranial first approaches; and differences in outcomes of extracranial stenting at time of procedure versus angioplasty alone...
March 9, 2018: Journal of Neurointerventional Surgery
S P Ban, O-K Kwon, S U Lee, J S Bang, C W Oh, H J Jeong, M J Cho, E-A Jeong, T Kim
BACKGROUND AND PURPOSE: During stent-assisted coiling of ICA aneurysms, stent tips are sometimes unintentionally embedded into ICA branches. Stent tips can be visualized because they have radiopaque markers. Concerns regarding stent tip misplacement include risks of artery perforation and occlusion. The aim of this study was to evaluate the long-term outcomes of ICA branches with embedded stent tips. MATERIALS AND METHODS: ICA branches with embedded stent tips were identified among 35 patients with unruptured ICA aneurysms treated with stent-assisted coiling between November 2003 and November 2014...
March 8, 2018: AJNR. American Journal of Neuroradiology
Tomonori Iwata, Takahisa Mori, Yuhei Tanno, Shigen Kasakura, Kazuhiro Yoshioka
BACKGROUND: Cerebral hyperperfusion syndrome (CHS) is likely to occur after carotid revascularization in patients with stage 2 hemodynamic failure (st2HF), in whom the oxygen extraction fraction (OEF) increases. OBJECTIVE: The purpose of our study was to investigate whether measurement of the global cerebral OEF (gcOEF) by blood sampling can be used to estimate st2HF and anticipate CHS following carotid artery stenting (CAS). METHODS: The OEF was calculated by blood sampling just before and after elective CAS...
March 6, 2018: Journal of Neurointerventional Surgery
Emma van der Weijde, Nabil Saouti, Jan Albert Vos, Selma C Tromp, Robin H Heijmen
OBJECTIVES: To evaluate the indications, perioperative strategy and postoperative outcome of surgical left subclavian artery (LSA) revascularization combined with thoracic endovascular aortic repair (TEVAR) covering the LSA. METHODS: Between 2000 and 2017, a total of 101 consecutive patients underwent surgical revascularization of the LSA prior to, concomitant or following TEVAR. Revascularization was performed through a small supraclavicular incision and consisted of a transposition or bypass graft, using intraoperative transcranial Doppler monitoring...
February 28, 2018: Interactive Cardiovascular and Thoracic Surgery
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