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Carotid angioplasty

Zhengze Dai, Jie Gao, Shun Li, Rongrong Li, Zhaoyao Chen, Meng Liang, Xinfeng Liu, Gelin Xu
BACKGROUND AND PURPOSE: Platelet aggregation plays a vital role in the development of in-stent restenosis (ISR) after carotid angioplasty and stenting (CAS). Mean platelet volume (MPV) has been suggested as an index of platelet reactivity. This study aimed to investigate the association between MPV and ISR in CAS patients. METHODS: A total of 261 patients with CAS were enrolled. MPV was measured before CAS procedure. Digital subtraction angiography, computed tomographic angiography, or duplex ultrasonography was performed at 6 months and annually after the procedure...
March 20, 2018: Stroke; a Journal of Cerebral Circulation
Jian Yang, Ping Zeng, Jun Yang, Xiaowen Liu, Jiawang Ding, Huibo Wang, Lihua Chen
PURPOSE: Hyperglycemia is the high risk factor of vascular remodeling induced by angioplasty, and neointimal hyperplasia is strongly implicated in the pathogenesis of vascular remodeling caused by carotid artery balloon injury. Studies have shown that MicroRNA 24 (miR-24) plays an important role in angiocardiopathy, However, the role of miR-24 is far from thorough research. In this study, we investigate whether up-regulation of miR-24 by using miR-24 recombinant adenovirus (Ad-miR-24-GFP) can inhibit PDGF-BB signaling pathway and attenuate vascular remodeling in the diabetic rat model...
March 17, 2018: Gene
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
Yoko Kaneko, Takamoto Yanagawa, Yoshinori Taru, Sonoko Hayashi, Hong Zhang, Tomoki Tsukahara, Tsuneaki Matsunaga, Takashi Ishizu
INTRODUCTION: We describe a hemodialysis patient who developed subclavian steal syndrome via an arteriovenous fistula after percutaneous transluminal angioplasty. CASE DESCRIPTION: A 55-year-old female with end-stage renal failure due to polycystic kidney disease had been treated with hemodialysis for 10 years. Because of an autologous arteriovenous fistula stenosis, percutaneous transluminal angioplasty was performed. After successful treatment with percutaneous transluminal angioplasty, the patient developed dizziness...
March 1, 2018: Journal of Vascular Access
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
Gianfranco Varetto, Alessandra Trevisan, Giovanni Barile, Lorenzo Gibello, Flavia Spalla, Edoardo Frola, Daniele Pennica, Pietro Rispoli PhD
BACKGROUND: Pseudoaneurysm (PA) after carotid endarterectomy (CEA) is a rare and potentially life-threatening complication, with an incidence lower than 1%. Most of the cases described report PAs after carotid patch angioplasty and are associated with infection, often caused by Staphylococci. The management of PAs can be surgical, endovascular, or hybrid. METHODS: We herein present the case of an infected carotid PA 27 days after an eversion CEA. We performed a common to internal carotid bypass with the interposition of great saphenous vein (GSV) associated with specific polyantibiotic therapy for 4 weeks...
January 1, 2018: Vascular and Endovascular Surgery
David Rafael Santiago-Dieppa, Jeffrey A Steinberg, Michael G Brandel, Robert C Rennert, Vincent J Cheung, Arvin Raj Wali, Scott Eric Olson, Alexander Arash Khalessi, Jeffrey Scott Pannell
BACKGROUND: Crossing a nascently deployed carotid artery stent (CAS) is required to perform angioplasty and filter recapture. If the traversing balloon or filter recapture catheters are eccentric or tangentially angled to the vertical axis of the CAS they can ensnare on the ledge of the proximal CAS step-off, potentially causing life-threatening complications secondary to deformation, displacement, or mechanical occlusion of the stent. We report a novel "balloon bridge" technique that facilitates safe entry and passage across the CAS with both a balloon catheter and an LBGC...
February 23, 2018: World Neurosurgery
Warner A Oldenburg, Tariq Almerey, Mahmoud Selim, Houssam Farres, Albert G Hakaim
BACKGROUND: Multiple studies have shown that patch angioplasty following carotid endarterectomy (CEA) reduces the risk of stroke and restenosis when compared with primary closure. Biological, synthetic, or vein patches have been traditionally used in CEA. This paper reports the early and long term outcomes of bovine pericardium (BP) for patch angioplasty in CEA. . METHODS: Retrospective, consecutive analysis of 874 patients who underwent CEA during the past 17 years at Mayo Clinic Florida was performed...
February 23, 2018: Annals of Vascular Surgery
Esther Bae, Trung Duong Vo
Atherosclerotic carotid stenosis associated with a mobile carotid plaque (MCP) is a relatively rare entity, observed in less than 1 in 2000 carotid ultrasound examinations. As such, the natural history of this lesion and risk for neurological thromboembolic complications are not well defined. Small case reports have described treatment varying from medical management with anticoagulation, to carotid endarterectomy, and more recently, carotid stenting. We present two patients with carotid stenosis associated with a mobile carotid plaque...
February 22, 2018: Annals of Vascular Surgery
Costas Tsioufis, Ioannis Andrikou, Gerasimos Siasos, Konstantinos Filis, Dimitrios Tousoulis
Peripheral artery disease (PAD) affects more than 200 million people worldwide. Hypertension has been related to increased risk of PAD. The treatment of elevated blood pressure (BP) in these patients is indicated to lower the cardiovascular risk with a BP goal of less than 130/80mmHg. Although there is no evidence that one class of antihypertensive medication or strategy is superior for BP lowering in PAD, the use of renin-angiotensin-system (RAS) inhibitors can be effective to reduce the cardiovascular risk...
February 16, 2018: Current Opinion in Pharmacology
Mojtaba Rismanchi, Afshin Borhani-Haghighi
Background: The purpose of this study was to compare the frequency of microembolic brain infarcts after direct navigation method versus exchange method in carotid artery stenting and vertebral artery origin angioplasty. Methods and Material: This is a prospective study conducted at Shiraz University of Medical Sciences in southern Iran. Consecutive patients undergoing "carotid angioplasty and stenting" and "vertebral artery origin stenting" were randomly assigned into two groups with "direct navigation method" and "exchange method...
December 2017: Journal of Vascular and Interventional Neurology
Georgios Sahsamanis, Georgios Vourliotakis, Konstantinos Pirgakis, Anastasios Lekkas, Ioannis Kantounakis, Alexandra Terzoglou, Vasileios Tzilalis
BACKGROUND: Right-sided subclavian artery stenosis is a rare cerebrovascular disease involving the upper extremities. Considering an endovascular approach for its management requires increased endovascular and catheterization skills, when compared to the left side, due to the close approximation of the right subclavian artery origin, vertebral and common carotid arteries. METHODS: Three patients suffering from proximal right sided subclavian artery stenosis were treated in our center through primary stenting...
February 5, 2018: Annals of Vascular Surgery
Caitlin W Hicks, Besma Nejim, Tammam Obeid, Satinderjit S Locham, Mahmoud B Malas
BACKGROUND: Primary carotid stenting (PCS) has been shown to be feasible and safe in small series, but real-world outcomes in a large multicenter data set have yet to be explored. We aimed to compare outcomes for PCS (PCS+) vs conventional carotid artery stenting (CAS) with angioplasty (PCS-) using a national database. METHODS: We analyzed all CAS cases in the Vascular Quality Initiative (VQI) database (2005-2016) using univariable and multivariable logistic regression to assess the effect of PCS on outcomes...
February 1, 2018: Journal of Vascular Surgery
Christoph Knappich, Andreas Kuehnl, Pavlos Tsantilas, Sofie Schmid, Thorben Breitkreuz, Michael Kallmayer, Alexander Zimmermann, Hans-Henning Eckstein
OBJECTIVE: The objective of this study was to describe characteristics and in-hospital outcomes of patients treated with carotid endarterectomy (CEA) and carotid artery stenting (CAS) for stroke in evolution (SIE) under routine conditions in Germany. METHODS: This secondary data analysis is based on the German statutory quality assurance database for carotid revascularization procedures. Patients with SIE who had undergone CEA or CAS were included. The primary outcome was any new stroke or all-cause death until hospital discharge...
January 27, 2018: Journal of Vascular Surgery
Andreia Coelho, Miguel Lobo, Ricardo Gouveia, Diogo Silveira, Jacinta Campos, Rita Augusto, Nuno Coelho, Alexandra Canedo
INTRODUCTION: Endovascular intracranial thrombectomy (IT) has established itself as the standard of care in treating large-vessel anterior circulation acute ischemic stroke (AIS). However, internal carotid artery (ICA) stenosis/occlusion hampers distal access and controversy about simultaneous emergency ICA stenting ensues. The purpose of this review was to evaluate the safety of emergency ICA stenting in combination with IT for AIS with tandem occlusions. To our knowledge this is the first meta-analysis to evaluate emergency ICA stenting in tandem occlusions, combining results from studies with a control group...
January 23, 2018: Journal of Cardiovascular Surgery
Brian Fletcher, Jaime De La Ree, James Drougas
Simulation in surgery is becoming an important component of surgical education. Training on bench top models has been demonstrated to improve technical skills. The objective of our project was to create a vascular surgery simulation model. The simulation model consists of a platform, artificial blood reservoir, artificial blood, inflow and outflow limbs, electric motor, battery, pulse generator, and cryopreserved vessel. Three different vascular surgery simulation stations were created: carotid endarterectomy with shunting and patch angioplasty, arterial bypass, and arteriovenous graft formation...
December 2017: Journal of Vascular Surgery Cases and Innovative Techniques
Maurizio Domanin, Maurizio Isalberti, Silvia Romagnoli, Antonio Rolli, Simona Sommaruga
Concerns about carotid artery stenting (CAS) center primarily on procedural complications like acute occlusion, stroke, and long-term intrastent restenosis. External carotid artery (ECA) thrombosis is observed during CAS follow-up, but it often remains asymptomatic or, at worst, results in jaw claudication. We report here a case of late occlusion of the ECA after CAS with symptoms of acute homolateral facial ischemia as well as pain, cyanosis, tongue numbness, and skin coldness. The patient was submitted to local thrombolysis and balloon angioplasty with regression of symptoms after recanalization...
June 2017: Journal of Vascular Surgery Cases and Innovative Techniques
Ilaria Tocco-Tussardi, Caterina Kulyk, Vincenzo Vindigni, Giampiero Avruscio
INTRODUCTION: Cerebral-protection devices (CPDs) are a well-established system for reduction of embolic risk in carotid artery angioplasty and stenting (CAS). Although rare, adverse events with CPDs are unpredictable and can be associated with serious outcomes and iatrogenic sequelae. PRESENTATION OF CASE: We describe the unique case of dislocation of a FilterWire EX™ filter loop during right CAS. On trying to recapture the CPD filter at the end of the procedure, the filter loop suddenly detached from the guidewire and dislocated to the proximal middle cerebral artery...
December 28, 2017: International Journal of Surgery Case Reports
Zahra Hasani, Rudolf W M Keunen, Dénes L J Tavy, Arne Mosch, Barry B Mook-Kanamori, Sebastiaan F T M De Bruijn, Ali M Keyhan-Falsafi, Gerard J F Hoohenkerk, Gayleen Stephens, Eric Teeuws, Jan van Alphen, Hans van Overhagen, Frank E E Treurniet, Lucas van Dijk, Paulien M van Kampen
OBJECTIVES: Reducing the rate of postoperative stroke after cardiac surgery remains challenging, especially in patients with occlusive cerebrovascular disease. Angioplasty in all patients with high-grade carotid artery stenosis has not been shown to be effective in reducing the post-surgical stroke rate. In this study, we present the initial results of a different approach using selective carotid angioplasty only in patients with poor intracranial collaterals. METHODS: We conducted a single-centre study to assess the safety of this procedure...
January 3, 2018: Interactive Cardiovascular and Thoracic Surgery
Chun-Hsu Pan, Pei-Chuan Li, Yi-Chung Chien, Wan-Ting Yeh, Chih-Chuang Liaw, Ming-Jyh Sheu, Chieh-Hsi Wu
Neointimal hyperplasia (or restenosis) is primarily attributed to excessive proliferation and migration of vascular smooth muscle cells (VSMCs). In this study, we investigated the inhibitory effects and mechanisms of ugonin J on VSMC proliferation and migration as well as neointimal formation. Cell viability and the cell-cycle distribution were, respectively, analyzed using an MTT assay and flow cytometry. Cell migration was examined using a wound-healing analysis and a transwell assay. Protein expressions and gelatinase activities were, respectively, measured using Western blot and gelatin zymography...
December 18, 2017: Phytotherapy Research: PTR
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