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.

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 Carotid Stenting without Angioplasty

2002 ◽  
Vol 29 (2) ◽  
pp. 175-179 ◽  
Author(s):  
S. Men ◽  
S.P. Lownie ◽  
D.M. Pelz
Keyword(s):  
Balloon Angioplasty ◽  
Plain Film ◽  
Carotid Bifurcation ◽  
Carotid Stenting ◽  
Vessel Diameter ◽  
Moderate Increase ◽  
Atherosclerotic Stenosis ◽  
Hemodynamic Improvement ◽  
Angioplasty And Stenting ◽  
Carotid Angioplasty And Stenting

Abstract:Background:Carotid angioplasty and stenting is gaining popularity as an alternative to carotid endarterectomy for the treatment of carotid bifurcation stenosis. The major concern with the procedure is the risk of embolic stroke which may be initiated by balloon angioplasty of friable atherosclerotic plaque. Elimination of angioplasty may result in a lower incidence of embolic complications.Method:We describe a case in which a self-expanding stent alone, without balloon angioplasty, was used to successfully dilate an atherosclerotic stenosis of the carotid bifurcation.Results:A moderate increase in vessel diameter, from 75% to 50%, was immediately observed after stent placement alone. No embolic complications were observed and follow-up plain film and ultrasound examinations showed progressive stent enlargement with excellent anatomic and hemodynamic results.Conclusions:In this case of severe carotid stenosis, the use of a self-expanding stent alone, without balloon angioplasty, resulted in excellent anatomic and hemodynamic improvement.

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.

Association between carotid plaque composition assessed by multidetector computed tomography and cerebral embolism after carotid stenting

2011 ◽  
Vol 54 (5) ◽  
pp. 487-493 ◽  
Author(s):  
Naoyuki Uchiyama ◽  
Kouichi Misaki ◽  
Masanao Mohri ◽  
Takuya Watanabe ◽  
Yuichi Hirota ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Multidetector Computed Tomography ◽  
Carotid Plaque ◽  
Carotid Stenting ◽  
Cerebral Embolism ◽  
Plaque Composition

Management of Mobile Floating Carotid Plaque Using Carotid Artery Stenting

2003 ◽  
Vol 10 (3) ◽  
pp. 653-656 ◽  
Author(s):  
Elie Y. Chakhtoura ◽  
Jonathan E. Goldstein ◽  
Robert W. Hobson
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Carotid Plaque ◽  
Case Reports ◽  
Duplex Ultrasound ◽  
Carotid Stenting ◽  
Clinical Results ◽  
Unique Nature ◽  
Risk Patients ◽  
Ischemic Attack

Purpose: To present management techniques for dealing with mobile floating carotid plaque (MFCP), which represents an indeterminate risk of embolic cerebrovascular events. Case Reports: Two high-risk patients with a history of carotid endarterectomy were diagnosed with MFCP by duplex ultrasound scanning. One patient had a left hemispheric transient ischemic attack while the other was asymptomatic with a moderate stenosis. Both were successfully treated with carotid artery stenting, achieving complete coverage of the MFCP. Their outcomes were uneventful, and sustained patency of the stented arteries has been observed during an event-free survival of 32 and 44 months, respectively. Conclusions: Based upon the unique nature of these lesions and our satisfactory clinical results, we believe that carotid stenting may be a viable option for the treatment of MFCP.

scholarly journals Carotid Plaque Echolucency Increases the Risk of Stroke in Carotid Stenting

Circulation ◽  
2004 ◽  
Vol 110 (6) ◽  
pp. 756-762 ◽  
Author(s):  
Giorgio M. Biasi ◽  
Alberto Froio ◽  
Edward B. Diethrich ◽  
Gaetano Deleo ◽  
Stefania Galimberti ◽  
...  
Keyword(s):  
Carotid Plaque ◽  
Carotid Stenting
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