Carotid Stenting and Redo Carotid Endarterectomy in Patient with Bilateral Recurrent Carotid Stenosis with Type III Aortic Arch

2020 ◽  
pp. 381-383
Author(s):  
Sachinder Singh Hans
Keyword(s):  
Carotid Endarterectomy ◽  
Carotid Stenosis ◽  
Aortic Arch ◽  
Carotid Stenting ◽  
Type Iii

Endovascular Advances for Extracranial Carotid Stenosis

Neurosurgery ◽  
2014 ◽  
Vol 74 (suppl_1) ◽  
pp. S92-S101 ◽  
Author(s):  
Jorge L. Eller ◽  
Travis M. Dumont ◽  
Grant C. Sorkin ◽  
Maxim Mokin ◽  
Elad I. Levy ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Endarterectomy ◽  
Carotid Stenosis ◽  
Carotid Artery Stenosis ◽  
Carotid Artery Stenting ◽  
Carotid Stenting ◽  
Historical Background ◽  
Treatment Modalities ◽  
Endovascular Management ◽  
The Past

Abstract Carotid artery stenting has become a viable alternative to carotid endarterectomy in the management of carotid stenosis. Over the past 20 years, many trials have attempted to compare both treatment modalities and establish the indications for each one, depending on clinical and anatomic features presented by patients. Concurrently, carotid stenting techniques and devices have evolved and made endovascular management of carotid stenosis safe and effective. Among the most important innovations are devices for distal and proximal embolic protection and new stent designs. This paper reviews these advances in the endovascular management of carotid artery stenosis within the context of the historical background.

scholarly journals Why carotid endarterectomy is method of choice in treatment of carotid stenosis

2008 ◽  
Vol 136 (3-4) ◽  
pp. 181-186 ◽  
Author(s):  
Djordje Radak ◽  
Lazar Davidovic
Keyword(s):  
Carotid Endarterectomy ◽  
Carotid Stenosis ◽  
Stent Implantation ◽  
Radical Neck Dissection ◽  
Carotid Stenting ◽  
Long Term Results ◽  
Radiation Induced ◽  
The Common ◽  
Graft Interposition

Procedures used in treatment of carotid stenosis are endarterectomy, PTA with stent implantation, resection with graft interposition and by-pass procedure. Segmental lesions are found more often and treated by the first two mentioned procedures. In case of longer lesions and extension to the greater part of the common carotid artery, the other two procedures are performed. For the past few years, the main dilemma has been whether to perform carotid endarterectomy or PTA with stent implantation. Both early and long-term results speak in favour of carotid endarterectomy, regardless of an increased number of PTA and carotid stenting. At the same time, PTA and carotid stenting are more expensive procedures. Both methods have their defined and important roles in treatment of segmental occlusive carotid lesions. Severe cardiac, pulmonary and renal conditions, which increase the risk of general anaesthesia, are not an absolute indication for PTA and stenting, since endarterectomy can be done in regional anaesthesia. Main indications for PTA with stent implantation are: surgically inaccessible lesions (at or above C2; or subclavian); radiation- induced carotid stenosis; prior ipsilateral radical neck dissection; prior carotid endarterectomy (restenosis).

Obstructed Flow

2016 ◽  
Author(s):  
Ji Y. Chong ◽  
Michael P. Lerario
Keyword(s):  
Carotid Endarterectomy ◽  
Carotid Stenosis ◽  
Transient Ischemic Attack ◽  
Recurrent Stroke ◽  
Early Period ◽  
Carotid Stenting ◽  
Symptomatic Carotid ◽  
Symptomatic Carotid Stenosis ◽  
Ischemic Attack

Patients with symptomatic carotid stenosis benefit from revascularization. The risk of recurrent stroke is highest during the early period after a transient ischemic attack or stroke. Carotid endarterectomy and carotid stenting are options for treatment and should be considered within the first 2 weeks if feasible.

Transradial Stenting for Carotid Stenosis in Patients with Bovine Type and Type III Aortic Arch: Experience in 28 Patients

2018 ◽  
Vol 111 ◽  
pp. e661-e667 ◽  
Author(s):  
Bu-Lang Gao ◽  
Gang-Qin Xu ◽  
Zi-Liang Wang ◽  
Tian-Xiao Li ◽  
Yong-Feng Wang ◽  
...  
Keyword(s):  
Carotid Stenosis ◽  
Aortic Arch ◽  
Type Iii ◽  
Bovine Type

scholarly journals Treatment Strategy for Bilateral Carotid Stenosis: 2 Cases of Carotid Endarterectomy for the Symptomatic Side Followed by Carotid Stenting

2014 ◽  
Vol 23 (10) ◽  
pp. 2851-2856 ◽  
Author(s):  
Masaaki Hokari ◽  
Masanori Isobe ◽  
Takeshi Asano ◽  
Yasuhiro Itou ◽  
Kazuyoshi Yamazaki ◽  
...  
Keyword(s):  
Carotid Endarterectomy ◽  
Carotid Stenosis ◽  
Treatment Strategy ◽  
Carotid Stenting ◽  
Bilateral Carotid ◽  
Symptomatic Side

scholarly journals TCT-510 Bovine arch vs aortic arch type III. The importance of the type of complex aortic arch in carotid stenting.

2013 ◽  
Vol 62 (18) ◽  
pp. B155
Author(s):  
Felix Damas de los Santos ◽  
fausto Castriota ◽  
Federico Colombo ◽  
Alberto Cremonesi ◽  
chiara grattoni ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Carotid Stenting ◽  
Type Iii ◽  
Bovine Arch

Carotid Endarterectomy Versus Carotid Stenting to Treat Carotid Stenosis

2018 ◽  
Vol 268 (2) ◽  
pp. e31
Author(s):  
Demetrios Moris ◽  
Georgios Karaolanis ◽  
Eleftherios Spartalis ◽  
Sotirios Georgopoulos
Keyword(s):  
Carotid Endarterectomy ◽  
Carotid Stenosis ◽  
Carotid Stenting

scholarly journals Carotid Stenting in Asymptomatic Carotid Stenosis: The Calgary Experience

2010 ◽  
Vol 37 (5) ◽  
pp. 568-573 ◽  
Author(s):  
N. Shobha ◽  
M. A. Almekhlafi ◽  
A. Pandya ◽  
P. L. Couillard ◽  
W. F. Morrish ◽  
...  
Keyword(s):  
Carotid Endarterectomy ◽  
Carotid Stenosis ◽  
Medical Center ◽  
Carotid Stenting ◽  
Minor Stroke ◽  
Safe Procedure ◽  
Asymptomatic Group ◽  
Symptomatic Group ◽  
Asymptomatic Patients

Background:Although carotid endarterectomy is considered the ‘gold standard’ for standard risk symptomatic patients, the treatment of choice for asymptomatic patients remains controversial. Carotid stenting has demonstrated real-world outcomes consistent with established guidelines for carotid endarterectomy in asymptomatic high-surgical risk patients in recent prospective multicenter trials. We describe our experience with asymptomatic patients who underwent carotid stenting at our center in a routine clinical setting.Methods:This is a retrospective, longitudinal cohort study of patients who underwent carotid angioplasty and stenting at the Foothills Medical Center, Calgary, Canada between 1997 and 2007. The qualifying events were categorized as symptomatic and asymptomatic. The procedures were performed by four experienced neurointerventionists. The primary outcome was stroke or death at 30-day follow- up.Results:243 patients underwent 255 carotid stenting procedures. Their ages ranged from 50 to 83 years; the mean age was 72.0 ± 9.3 years; 67(26.3%) were women. Forty one patients (16.1%) were asymptomatic; 214 patients (83.9%) were symptomatic. The patients in the asymptomatic group were significantly younger - 66.0 ± 8.8 years compared to patients in the symptomatic group 73.2 ± 8.9 years (p<0.0001). Intraprocedurally one minor stroke (2.4%) occurred in the asymptomatic group. At 30-day follow-up, no deaths or further strokes were noted in the asymptomatic group; while eight deaths, six major and seven minor strokes occurred in the symptomatic group (p=0.22).Conclusion:Carotid stenting appears to be a safe procedure in asymptomatic patients with severe carotid stenosis in routine clinical settings as witnessed in this single center study.

scholarly journals Redo Carotid Endarterectomy Versus Primary Carotid Endarterectomy

Stroke ◽  
2001 ◽  
Vol 32 (suppl_1) ◽  
pp. 332-332
Author(s):  
Ali F AbuRahma ◽  
Tucker G Jennings ◽  
John T Wulu ◽  
Lisa Tarakji ◽  
Patrick A Robinson
Keyword(s):  
Carotid Endarterectomy ◽  
Carotid Stenosis ◽  
Nerve Injury ◽  
Cranial Nerve ◽  
Survival Rates ◽  
Carotid Stenting ◽  
Free Survival ◽  
Perioperative Stroke ◽  
Cranial Nerve Injury ◽  
Patch Closure

90 Background/Purpose: Several authorities have recently advocated carotid stenting for recurrent carotid stenosis because of the perception that redo surgery carries a higher complication rate than primary carotid endarterectomy (CEA). This study will compare early and late results of reoperations versus primary CEA. Patient Poplulation and Methods: All redo operations for recurrent carotid stenosis performed during a recent 7-year period by a single vascular surgeon were compared with primary CEA. Since all redo CEAs were done using polytetrafluoroethylene (PTFE) or vein patch closure, only primary CEAs using the same patching were analyzed. A Kaplan Meier life-table analysis was used to estimate stroke-free survival rates and freedom from ≥50% recurrent stenosis. Results: Out of 510 primary CEAs, 265 had PTFE or vein patch closure. One hundred twenty-four reoperations using PTFE or vein patch closure were done during the same period. Both groups had similar demographic characteristics. Indications for reoperations and primary CEAs were symptomatic stenosis in 78% and 58%, and asymptomatic ≥80% stenosis in 22% and 42%, respectively (p<0.001). The 30-day perioperative stroke and transient ischemic attack rates for reoperation and primary CEA were 4.8% versus 0.8% (p=0.015) and 4% versus 1.1%, respectively, with no perioperative deaths in either group. Cranial nerve injury was noted in 17% in reoperation patients versus 5.3% in primary CEA patients, however most of these were transient (p<0.001). The mean hospital stay was 1.8 days for reoperation versus 1.6 days for primary CEA. The cumulative stroke-free survival and freedom from ≥50% recurrent stenosis rates for reoperation at 1, 3, and 5 years were 96%, 91%, 82%, and 98%, 96%, 95%, respectively; and 94%, 92%, 91% and 98%, 96%, 96%, respectively for primary CEA (no statistically significant differences). Conclusions: Reoperation carries higher perioperative stroke and cranial nerve injury rates than primary CEA. However, redo operations are durable and have stroke-free survival rates that are similar to primary CEA. These considerations should be kept in mind when recommending carotid stenting versus reoperation.

Symptomatic carotid stenosis in the setting of bilateral disease and coexisting carotid body tumor: management with a carotid stent and staged excision

Vascular ◽  
2013 ◽  
Vol 21 (6) ◽  
pp. 396-399 ◽  
Author(s):  
Matthew Smeds ◽  
Donald Jacobs
Keyword(s):  
Carotid Artery ◽  
Carotid Endarterectomy ◽  
Carotid Stenosis ◽  
Carotid Body ◽  
Carotid Stenting ◽  
Carotid Body Tumor ◽  
Carotid Stent ◽  
Symptomatic Carotid ◽  
Symptomatic Carotid Stenosis ◽  
Bilateral Carotid

The aim of the paper is to describe the management of a patient with bilateral carotid artery stenosis, symptomatic on the left, with coexisting left carotid body tumor with left carotid stenting followed by right carotid endarterectomy and excision of carotid body tumor. A 60-year-old man with significant bilateral carotid stenosis was referred to us with symptomatic left carotid disease and concomitant left carotid body tumor. A Precise nitinol carotid stent (Cordis Endovascular, Miami Lakes, FL, USA) was placed in his left carotid artery followed by interval carotid endarterectomy on the right. Excision of the carotid body tumor was then performed. Carotid stenting is a treatment option in patients with carotid stenosis and coexisting carotid body tumor. To our knowledge, this is the first reported carotid stent for symptomatic carotid stenosis in a patient with a concomitant carotid body tumor.

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