scholarly journals Current status of carotid bifurcation angioplasty and stenting based on a consensus of opinion leaders

2001 ◽  
Vol 33 (2) ◽  
pp. 111-116 ◽  
Author(s):  
Frank J. Veith ◽  
Max Amor ◽  
Takao Ohki ◽  
Hugh G. Beebe ◽  
Peter R.F. Bell ◽  
...  
Keyword(s):  
Carotid Bifurcation ◽  
Opinion Leaders ◽  
Current Status ◽  
Angioplasty And Stenting

Current concepts of the interventional treatment of proximal supraaortic vessel stenosis

VASA ◽  
2012 ◽  
Vol 41 (5) ◽  
pp. 313-318 ◽  
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.

Carotid Angioplasty

1999 ◽  
Vol 5 (1_suppl) ◽  
pp. 61-65
Author(s):  
G. Duckwiler ◽  
Y.P. Gobin ◽  
F. Viñuela
Keyword(s):  
Insurance Coverage ◽  
Patient Characteristics ◽  
The United States ◽  
Current Status ◽  
Carotid Angioplasty ◽  
Operator Experience ◽  
Angioplasty And Stenting ◽  
Carotid Angioplasty And Stenting ◽  
Do So ◽  
The Ideal

Although no consensus yet exists on the ideal patient characteristics, materials, and indications for carotid angioplasty, it is clear that this procedure which is increasing in popularity will continue to do so. Until such time as the procedure is routinely approved (there are still barriers to insurance coverage for these procedures in the United States), we are highly selective in our application of carotid angioplasty. So far our experience is limited to approximately 40 patients with no major complications and no strokes. However, patient characteristics, operator experience, and patient selection play large roles in the outcomes of these procedures. The current status of carotid angioplasty and stenting wilt be discussed as well as the potential complications and their treatment.

Transcervical Carotid Stenting with Flow Reversal for Neuroprotection: Technique, Results, Advantages, and Limitations

Vascular ◽  
2006 ◽  
Vol 14 (5) ◽  
pp. 245-255 ◽  
Author(s):  
Iraklis I. Pipinos ◽  
Matias Bruzoni ◽  
Jason M. Johanning ◽  
G. Matthew Longo ◽  
Thomas G. Lynch
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Carotid Bifurcation ◽  
Carotid Stenting ◽  
Flow Reversal ◽  
Transcervical Approach ◽  
Weighted Magnetic Resonance Imaging ◽  
Carotid Occlusive Disease ◽  
Angioplasty And Stenting ◽  
Carotid Angioplasty And Stenting

Carotid angioplasty and stenting are progressively earning a role as a less invasive alternative in the treatment of carotid occlusive disease. The most common approach for carotid artery stenting involves transfemoral access and use of a filter or balloon device for neuroprotection. This approach has limitations related to both the site of access and the method of neuroprotection. Specifically, an aortoiliac segment with advanced occlusive or aneurysmal disease or an anatomically unfavorable or atheromatous arch and arch branches can significantly limit the safety of the retrograde transfemoral pathway to the carotid bifurcation. Additionally, data provided by the use of transcranial Doppler monitoring and diffusion-weighted magnetic resonance imaging in patients undergoing filter- or balloon-protected carotid artery stenting demonstrate that currently available devices are associated with a considerable incidence of cerebral embolization. To address these limitations, we, along with others, have employed a direct transcervical approach for carotid artery stenting that incorporates the principle of flow reversal for neuroprotection. The technique bypasses all of the anatomic limitations of transfemoral access and simplifies the application of flow reversal, which is one of the safest neuroprotection techniques. The purpose of this review is to describe our method of transcervical carotid artery stenting, review the accumulating outcomes data, and discuss the clinical advantages of and indications for this increasingly popular technique.

scholarly journals Brain Protection with Intracarotid Filter in Angioplasty and Stenting of the Cervical Carotid Bifurcation

2001 ◽  
Vol 7 (2) ◽  
pp. 103-110 ◽  
Author(s):  
G. Bonaldi ◽  
G. Minonzio ◽  
A. Lunghi
Keyword(s):  
Carotid Plaque ◽  
Solid Material ◽  
Carotid Bifurcation ◽  
Carotid Stenting ◽  
Brain Protection ◽  
Balloon Inflation ◽  
Technical Aspects ◽  
Functional Factors ◽  
Angioplasty And Stenting ◽  
Carotid Flow

We report our preliminary experience in five cases of carotid stenting and angioplasty performed under cerebral protection with new filter devices allowing carotid flow maintenance during the procedure. In four out of five cases solid material was found inside the filters after balloon inflation for angioplasty. The technical aspects are discussed with correlation to carotid plaque embolic behavior and to functional factors.

scholarly journals Current Status and Future Perspective of Stenting for Symptomatic Intracranial Atherosclerotic Disease: A Meta-Analysis

2017 ◽  
Vol 2017 ◽  
pp. 1-11
Author(s):  
Zhong-Hao Li ◽  
Zhen-Hua Zhou ◽  
Xian-Jin Zhu ◽  
Wei Liu ◽  
Ya-Wen Chen ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Medical Therapy ◽  
Meta Analysis ◽  
Transluminal Angioplasty ◽  
Atherosclerotic Disease ◽  
Current Status ◽  
Future Perspective ◽  
Cochrane Library ◽  
Intracranial Atherosclerotic Disease ◽  
Angioplasty And Stenting

The aim of this study was to evaluate the safety and effectiveness of percutaneous transluminal angioplasty and stenting (PTAS) for intracranial atherosclerotic disease (ICAD) by conducting a meta-analysis. Two independent observers searched PubMed, EMBASE, and Cochrane Library for relevant studies up to 31 December 2016. A meta-analysis was conducted using Review Manager 5.3. Three studies involving 581 cases were included. The meta-analysis indicated that any stroke (RR = 3.13; 95% CI: 1.80–5.42), ischemic stroke (RR = 2.15; 95% CI: 1.19–3.89), and intracranial hemorrhage (RR = 14.71; 95% CI: 1.96–110.48) within 30 days in medical therapy alone were lower compared with PTAS plus medical therapy, but there were no significant differences in any stroke and ischemic stroke beyond 30 days between the two groups. There were also no significant differences in any death and myocardial infarction between the two groups. This meta-analysis demonstrated that, compared with medical therapy alone, PTAS for ICAD had a high risk of complication, but most complications in PTAS group occurred within 30 days after the operation, and beyond 30 days the PTAS was not inferior compared with medical therapy alone. Further studies are needed to reduce the periprocedural complications and reappraise the PTAS.

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