Emergent thoracic aortic angioplasty and stenting for middle aortic syndrome in non-specific aortitis

Background: Intracranial atherosclerotic stenosis is a major cause of stroke and yet there are currently no proven effective treatments for it. The SAMMPRIS trial, comparing aggressive medical management alone with aggressive medical management combined with intracranial angioplasty and stenting, was prematurely halted when an unexpectedly high rate of periprocedural events was found in the endovascular arm. The goal of our study is to report the immediate and long-term outcomes of patients with ≥ 70 % symptomatic intracranial atherosclerotic stenosis treated with balloon angioplasty and stent placement in a single centre. Patients and methods: This is a retrospective review of 37 consecutive patients with 42 procedures of ballon angioplasty and stenting for intracranial atherosclerotic stenosis (≥ 70 % stenosis) treated between 1999 and 2012. Technical success (residual stenosis ≤ 50 %), periprocedural success (no vascular complications within 72 hours), and long-term outcomes are reported. Results: Technical and periprocedural success was achieved in 90.5 % of patients. The within 72 hours periprocedural stroke/death rate was 7.1 % (4.8 % intracranial haemorrhage), and the 30-day stroke/death rate was 9.5 %. Thirty patients (81 %) had clinical follow-up at ≥ 6 months. During follow-up, 5 patients developed 6 ischemic events; 5 of them (17 %) were ipsilateral. The restenosis rate was 27 %, and the retreatment rate was 12 %. Conclusions: Our outcomes of the balloon angioplasty/stent placement for intracranial atherosclerotic stenosis are better than those in the SAMMPRIS study and compare favourably with those in large registries and observational studies.

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Current concepts of the interventional treatment of proximal supraaortic vessel stenosis

VASA ◽

10.1024/0301-1526/a000216 ◽

2012 ◽

Vol 41 (5) ◽

pp. 313-318 ◽

Cited By ~ 5

Author(s):

Ernemann ◽

Bender ◽

Melms ◽

Brechtel ◽

Kobba ◽

...

Keyword(s):

Treatment Strategies ◽

Carotid Bifurcation ◽

Current Treatment ◽

Long Term Results ◽

Clinical Indication ◽

Interventional Treatment ◽

Special Focus ◽

Brachiocephalic Artery ◽

Treatment Concepts ◽

Angioplasty And Stenting

Interventional therapies using angioplasty and stenting of symptomatic stenosis of the proximal supraaortic vessels have evolved as safe and effective treatment strategies. The aim of this paper is to summarize the current treatment concepts for stenosis in the subclavian and brachiocephalic artery with regard to clinical indication, interventional technique including selection of the appropriate vascular approach and type of stent, angiographic and clinical short-term and long-term results and follow-up. The role of hybrid interventions for tandem stenoses of the carotid bifurcation and brachiocephalic artery is analysed. A systematic review of data for angioplasty and stenting of symptomatic extracranial vertebral artery stenosis is discussed with a special focus on restenosis rate.

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Outcome of carotid endarterectomy under local anaesthesia with respect to the patients’ risk profile

VASA ◽

10.1024/0301-1526.38.3.225 ◽

2009 ◽

Vol 38 (3) ◽

pp. 225-233 ◽

Cited By ~ 2

Author(s):

Aleksic ◽

Luebke ◽

Brunkwall

Keyword(s):

Myocardial Infarction ◽

High Risk ◽

Carotid Endarterectomy ◽

Complication Rate ◽

Local Anaesthesia ◽

High Risk Group ◽

High Risk Patients ◽

Hostile Neck ◽

Risk Patients ◽

Angioplasty And Stenting

Background: In the present study the perioperative complication rate is compared between high- and low-risk patients when carotid endarterectomy (CEA) is routinely performed under local anaesthesia (LA). Patients and methods: From January 2000 through June 2008 1220 consecutive patients underwent CEA under LA. High-risk patients fulfilled at least one of the following characteristics: ASA 4 classification, “hostile neck”, recurrent ICA stenosis, contralateral ICA occlusion, age ≥ 80 years. The combined complication rate comprised any new neurological deficit (TIA or stroke), myocardial infarction or death within 30 days after CEA, which was compared between patient groups. Results: Overall 309 patients (25%) were attributed to the high-risk group, which differed significantly regarding sex distribution (more males: 70% vs. 63%, p = 0,011), neurological presentation (more asymptomatic: 72% vs. 62%, p = 0,001) and shunt necessity (33% vs. 14%, p < 0,001). In 32 patients 17 TIAs and 15 strokes were observed. In 3 patients a myocardial infarction occurred. Death occurred in one patient following a stroke and in another patient following myocardial infarction, leading to a combined complication rate of 2,9% (35/1220). In the multivariate analysis only previous neurological symptomatology (OR 2,85, 95% CI 1,38-5,91) and intraoperative shunting (OR 5,57, 95% CI 2,69-11,55) were identified as independent risk factors for an increased combined complication rate. Conclusions: With the routine use of LA, CEA was not associated with worse outcome in high-risk patients. Considering the data reported in the literature, it does not appear justified to refer high-risk patients principally to carotid angioplasty and stenting (CAS) when LA can be chosen to perform CEA.

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Outcomes of Carotid Angioplasty and Stenting for Radiation-Associated Stenosis

Yearbook of Vascular Surgery ◽

10.1016/s0749-4041(08)70554-2 ◽

2007 ◽

Vol 2007 ◽

pp. 282-284

Author(s):

M.K. Eskandari

Keyword(s):

Carotid Angioplasty ◽

Angioplasty And Stenting ◽

Carotid Angioplasty And Stenting

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Assessment of quality of life in patients with the effects of transient ischemic stroke

East European Journal of Neurology ◽

10.33444/2411-5797.2016.6(12).37-39 ◽

2016 ◽

pp. 37-39

Author(s):

A. Babirad

Keyword(s):

Quality Of Life ◽

Ischemic Stroke ◽

Large Scale ◽

Cerebrovascular Diseases ◽

Control Measures ◽

Sociological Research ◽

Cerebrovascular Events ◽

Sf 36 ◽

Angioplasty And Stenting

Cerebrovascular diseases are a problem of the world today, and according to the forecast, the problem of the near future arises. The main risk factors for the development of ischemic disorders of the cerebral circulation include oblique and aging, arterial hypertension, smoking, diabetes mellitus and heart disease. An effective strategy for the prevention of cerebrovascular events is based on the implementation of large-scale risk control measures, including the use of antiagregant and anticoagulant therapy, invasive interventions such as atheromectomy, angioplasty and stenting. In this connection, the efforts of neurologists, cardiologists, angiosurgery, endocrinologists and other specialists are the basis for achieving an acceptable clinical outcome. A review of the SF-36 method for assessing the quality of life in patients with the effects of transient ischemic stroke is presented. The assessment of quality of life is recognized in world medical practice and research, an indicator that is also used to assess the quality of the health system and in general sociological research.

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