Carotid artery stenting

2010 ◽  
pp. 698-722
Author(s):  
Iqbal Malik
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Artery Bypass ◽  
Coronary Intervention ◽  
High Grade ◽  
The Third ◽  
Percutaneous Coronary ◽  
Ica Stenosis ◽  
Developed World

Stroke is the third leading cause of death in the developed world. Internal carotid artery (ICA) stenosis is a major correctable cause of ischaemic stroke, the risk being related to the degree of stenosis and the presence of recent symptoms. Carotid endarterectomy (CEA) has become the preferred method of treatment for patients with asymptomatic or symptomatic high-grade ICA stenosis, supplanting medical therapy alone. In coronary disease, the increasing use of percutaneous coronary intervention (PCI) has reduced the need for coronary artery bypass surgery (CABG). Unlike coronary stenting, where immediate relief of anginal symptoms can justify the procedure, carotid intervention is not usually done for haemodynamic or flow indications, but to reduce future emboli. For significant (greater than 50% angiographic) ICA stenosis, carotid artery stenting (CAS) is a reasonable alternative to CEA, but its true place is as yet undecided, and awaits the conclusion of several ongoing randomized trials.

Carotid artery stenting

2018 ◽  
pp. 681-702
Author(s):  
Iqbal Malik ◽  
Mohamed Hamady
Keyword(s):  
Diabetes Mellitus ◽  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Artery Bypass ◽  
High Grade ◽  
Invasive Treatment ◽  
The Third ◽  
Ica Stenosis ◽  
Developed World ◽  
Embolic Risk

Stroke can be debilitating or fatal, and is the third leading cause of death in the developed world. Correctable risk factors include the standard cardiovascular conditions of diabetes mellitus, hypertension, smoking, and hyperlipidaemia. Atrial fibrillation has to be sought and the need for anticoagulation to reduce embolic risk assessed. Stenosis of the internal carotid artery (ICA) is a major correctable cause of ischaemic stroke, the risk being related to higher degree of narrowing and the presence of recent symptoms. Coronary stenting or coronary artery bypass surgery can be used for immediate relief of anginal symptoms or to improve prognosis with haemodynamically significant stenoses. Carotid intervention is not usually done for haemodynamic or flow indications, but to reduce future emboli. Carotid endarterectomy (CEA) has become the preferred method of invasive treatment for patients with asymptomatic or symptomatic high-grade ICA stenosis. However, for significant (>50% angiographic) ICA stenosis, carotid artery stenting is a reasonable alternative to CEA. Its true place is as yet undecided, and awaits the conclusion of further randomized trials.

scholarly journals 35 Years Angiographic Follow Up Of Atherosclerotic Cardiovascular Disease Including Redo Cabg, Carotid Artery Stenting & Multiple Interventions To Saphenous Venous Grafts

2020 ◽  
Vol 3 (5) ◽  
pp. 01-02
Author(s):  
Arnab ghosh Chaudhury
Keyword(s):  
Cardiovascular Disease ◽  
Percutaneous Coronary Intervention ◽  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Coronary Intervention ◽  
Atherosclerotic Cardiovascular Disease ◽  
Venous Grafts ◽  
Percutaneous Coronary ◽  
Multiple Interventions

Percutaneous coronary intervention (PCI) has got more benefit as compared to redo CABG in terms of morbidity & mortality in patients presented with degenerated CABG grafts. We report a case of post CABG patient treated successfully with multiple PCI to SVG grafts- a 35 years follow up.

Clinical Implications of the SYNTAX Study

2009 ◽  
Vol 4 (1) ◽  
pp. 48 ◽  
Author(s):  
Patrick Serruys ◽  
Scot Garg ◽  
◽  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
De Novo ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Coronary Intervention ◽  
Syntax Score ◽  
Cerebrovascular Events ◽  
Percutaneous Coronary ◽  
Syntax Study ◽  
Better Than

Recent years have seen an ongoing debate as to whether coronary artery bypass graft (CABG) surgery or percutaneous coronary intervention (PCI) is the most appropriate revascularisation strategy for patients with coronary heart disease (CAD). The Synergy between Percutaneous Coronary Intervention with TAXUS and Cardiac Surgery (SYNTAX) study was conducted with the intention of defining the specific roles of each therapy in the management of de novo three-vessel disease or left main CAD. Interim results after 12 months show that PCI leads to significantly higher rates of major adverse cardiac or cerebrovascular events compared with CABG (17.8 versus 12.4; p=0.002), largely owing to increased rates of repeat revascularisation. However, CABG was much more likely to lead to stroke. Interestingly, categorisation of patients by severity of CAD complexity according to the SYNTAX score has shown that there are certain patients in whom PCI can yield results that are comparable to, if not better than, those achieved with CABG. Careful clinical evaluation and comprehensive assessment of CAD severity, alongside application of the SYNTAX score, can aid practitioners in selecting the most suitable therapy for each individual CAD patient.

Design and Rationale of the National Tunisian Registry of Percutaneous coronary Intervention: Protocol for a Prospective, Multicenter Trial (Preprint)

2020 ◽  
Author(s):  
Rania Hammami ◽  
Slim Boudiche ◽  
Rami Tlili ◽  
Nejeh Ben Hlima ◽  
Ahmed Jamel ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Clinical Epidemiology ◽  
Artery Bypass ◽  
Coronary Intervention ◽  
Long Term Results ◽  
Adverse Cardiovascular Event ◽  
Chronic Occlusion ◽  
Percutaneous Coronary ◽  
Intervention Protocol

BACKGROUND Coronary diseases remain the first cause of death in the world; the management of this condition has improved, thanks to new technical tools and multicentric registries. Recently in Tunisia, the number of intervention procedures has markedly increased, giving the explosion of cardiovascular risk factors among Tunisian people. OBJECTIVE The aim of the study was to investigate the in-hospital and one-year clinical outcome of patients treated with percutaneous coronary intervention (PCI) in Tunisia. METHODS We will conduct a prospective, multicentric, observational study including patients > 18 year-old who underwent a PCI between 31January and 30 June 2020. The primary end point are the occurrence of a major adverse cardiovascular event , defined as cardiovascular death, myocardial infarction, cerebrovascular accident, and target vessel revascularization with either repeat PCI or coronary artery bypass surgery (CABG). Secondary end-points consist in procedural success rate, stent thrombosis, and the rate of redo-PCI/CABG for in-stent restenosis. RESULTS Results will be available at the end of the study as well as the demographic profile and general risk profile of Tunisian patients undergoing PCI. The complexity level of procedures, as left main, bifurcation, chronic occlusion PCI will be analyzed and immediate as well as long term results will be determined. NATURE-PCI will be the first national multicentric registry of angioplasty in Africa. CONCLUSIONS This study would add data and provide a valuable opportunity for real-world clinical epidemiology and practice in the field of interventional cardiology in Tunisia with insights into the uptake of contemporary coronary artery disease in this developing region. CLINICALTRIAL clinicaltrials.gov

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