scholarly journals Outcomes after Endovascular Treatment of Symptomatic Patients with Takayasu's Arteritis

2011 ◽  
Vol 17 (2) ◽  
pp. 252-260 ◽  
Author(s):  
H.J. Kim ◽  
C-S. Lee ◽  
J.S. Kim ◽  
S.U. Kwon ◽  
J.L. Kim ◽  
...  

We report our experience with endovascular treatment of supra-aortic arteries and follow-up results in patients with Takayasu's arteritis (TA) presenting with neurological symptoms. Of the 20 patients with TA who underwent cerebral angiography for neurological manifestations between May 2002 and May 2009, 12 (11 females, one male; mean age, 39 years; range 31–56 years) underwent endovascular treatment and evaluated outcome for 21 lesions, including nine common carotid arteries, four vertebral arteries, four subclavian arteries, two internal carotid arteries, and one brachiocephalic artery. Eight patients underwent multiple endovascular procedures for different lesions in single or multiple stages. Mean angiographic and clinical follow-up durations were 34 months (range, 11–79 months) and 39 months (range 11–91 months), respectively. Technical success was achieved for 20 procedures in 11 patients. One procedure failed, with 50% residual stenosis after stenting due to dense calcification of vessel walls. There were no procedure-related complications. Restenosis occurred at two lesions in two patients were treated by re-stenting. Asymptomatic occlusion occurred at two lesions in one patient. Ten patients remained in 0–1 on the modified Rankin scale (mRs) during mean 39 months. One patient, however, had a score of 3 on mRs due to a traumatic contusion during follow-up. One patient died from cardiac failure 36 months after successful angioplasty. Our data suggest that endovascular treatment of symptomatic supra-aortic lesions of TA is effective and durable in selected patients with neurologic symptoms.

Author(s):  
O. Belyaeva ◽  
V. Mandal ◽  
N. Ananyeva ◽  
O. Berkovich ◽  
E. I. Baranova ◽  
...  

Severity of atherosclerosis of common carotid arteries in patients with abdominal obesity (aged from 30 to 55 years old) was evaluated by ultrasound duplex scan. Atherosclerotic plaques of common and/or internal carotid arteries were revealed in 35% of patients. Correlations were observed between intima-media thickness of the common carotid artery, blood pressure levels, waist circumference and metabolic parameters.


2019 ◽  
Vol 25 (4) ◽  
pp. 390-396 ◽  
Author(s):  
Ljubisa Borota ◽  
Ehab Mahmoud ◽  
Christoffer Nyberg

Aim of the study To present our experience in the treatment of iatrogenic dissections of extracranial internal carotid and vertebral arteries with the Neuroform Atlas stent. Materials and methods Between January 2017 and February 2018 we treated iatrogenic dissections of three internal carotid arteries and three vertebral arteries. These iatrogenic dissections occurred during the endovascular treatment of ruptured and unruptured intracranial aneurysms. The indication for stenting was haemodynamically significant, flow-limiting dissection with threatening flow arrest. In all six cases, the dissections were treated by placement of Neuroform Atlas stents in the dissected segments of internal carotid or vertebral arteries. Deployment of the stent was followed by the usual dual antiplatelet regimen. Results Single or multiple Neuroform Atlas stents were deployed without any technical difficulties, and blood flow was restored immediately after placement of the stents in all six cases. Midterm follow-up (6–8 months) showed complete reconstruction of the shape and lumen of all treated arteries, with negligible intimal hyperplasia. Conclusion Our results indicate that a favourable outcome can be achieved by treating iatrogenic dissections of extracranial internal carotid and vertebral arteries with the Neuroform Atlas stent.


1988 ◽  
Vol 69 (2) ◽  
pp. 263-268 ◽  
Author(s):  
Yuichiro Tanaka ◽  
Shigetoshi Chiba

✓ The interaction between oxyhemoglobin (oxyHb) and 5-hydroxytryptamine (5-HT) was investigated in an experimental model of isolated canine internal and common carotid arteries with insertion of stainless steel cannulae. Extraluminal application of 10−5 M oxyHb induced marked and long-lasting vasoconstriction in the internal carotid but not in the common carotid arteries. The 5-HT-induced vasoconstriction was potentiated significantly in both the internal and common carotid arteries. These potentiations were not influenced by the presence or absence of endothelium, a finding which was confirmed by vascular responses to intraluminal acetylcholine. It is concluded that the interaction between extraluminal oxyHb and intraluminal 5-HT may be one of the possible etiological factors behind the chronic phase of vascular spasm following subarachnoid hemorrhage.


2020 ◽  
pp. 46-53
Author(s):  
А.Н. Казанцев ◽  
К.П. Черных ◽  
Н.Э. Заркуа ◽  
Р.Ю. Лидер ◽  
К.Г. Кубачев ◽  
...  

Цель: сравнительный анализ госпитальных и отдаленных результатов открытой симультанной стратегии коронарного шунтирования + каротидной эндартерэктомии (КШ+КЭЭ) и гибридной стратегии чрескожного коронарного вмешательства + каротидной эндартерэктомии (ЧКВ+КЭЭ). Материалы и методы: В данное когортное, сравнительное, ретроспективное, открытое исследование включено 180 пациентов с сочетанным поражением коронарных и внутренних сонных артерий, направлявшихся на симультанное вмешательство или гибридную операцию в период с января 2011г по декабрь 2015г. и имевших сопоставимое поражение коронарного русла. Все исследуемые пациенты были разделены на две группы: группа 1 – КШ+КЭЭ (n=116) и группа 2 − ЧКВ+КЭЭ (n=64). В группе 1 средний период наблюдения составил 50±17 мес, в группе 2 – 53±17 мес. Комбинированная конечная точка включала в себя совокупность таких кардиоваскулярных событий, как: смерть + ИМ + ОНМК/ТИА. При критическом уровне значимости p<0,05 различия считались статистически достоверными. Результаты: в госпитальном периоде значимых различий по частоте осложнений получено не было. В группе 1 выявлено 2 летальных исхода (1,7%), 1 инфаркт миокарда (0,9%), 5 ишемических инсультов (4,3%). В группе 2 среди осложнений получено 3 кровотечения, потребовавших ревизии раны (4,7%) относительно 9 кровотечений группы КШ+КЭЭ, закончившихся ремедиастинотомией (7,8%), р=0,63. В отдаленном периоде наблюдения значимых различий по частоте неблагоприятных исходов получено не было, однако отмечено возрастание частоты комбинированной конечной точки в группе ЧКВ+КЭЭ против КШ+КЭЭ (15/64 (23,4%) vs 17/116 (14,9%), р = 0,2) за счет рестеноза/тромбоза стента, спровоцировавшего инфаркт миокарда и повторную незапланированную реваскуляризацию миокарда. Заключение: исследование не показало значимых различий результатов открытой и гибридной реваскуляризации миокарда и головного мозга. Однако выявлена тенденция в нарастании числа неблагоприятных кардиоваскулярных событий после ЧКВ+КЭЭ в отдаленном периоде относительно КШ+КЭЭ в виду возрастания числа тромбозов/рестенозов стента. Данная особенность подчеркивает преимущества более агрессивных методов реваскуляризации над интервенционными. Objective: A comparative analysis of the hospital and long-term results of the open strategy - simultaneous coronary artery bypass grafting + carotid endarterectomy (CABG+CEE) and the hybrid strategy - percutaneous coronary intervention + carotid endarterectomy (PCI+CEE). Materials and methods: This cohort, comparative, retrospective, open-label study included 180 patients with a comparable lesion of the coronary channel and combined lesions of the coronary and internal carotid arteries going for simultaneous intervention or a hybrid operation from January 2011 to December 2015. All studied patients were divided into two groups: Group 1 - CABG+CEE (n=116); Group 2 - PCI+CEE (n=64). In group 1, the average follow-up period was 50±17 months; in group 2 - 53±17 months. Results: in the in-hospital period, no significant differences in the frequency of complications were obtained. 2 deaths (1.7%), 1 myocardial infarction (0.9%) and 5 ischemic strokes (4.3%) were detected in group 1. There were 3 bleedings cases requiring wound revision (4.7%) in the PCI + CEE group versus 9 in the CABG + CEE group requiring remediastinotomy (7.8%), p=0.63. In the long-term follow-up no significant differences in the frequency of adverse outcomes were obtained, however, an increase in the combined endpoint frequency in the PCI+CEE group as compared to CABG+CEE group was noted (15/64 (23,4%) vs 17/116 (14,9%), р=0,2, due to the stent restenosis/thrombosis which provoked myocardial infarction and repeated unplanned myocardial revascularization. Conclusion: the study showed no significant differences when performing open or hybrid myocardium and brain revascularization. However there is a tendency to increase the number of adverse cardiovascular events in the long-term period after PCI+CEE as compared to CABG+CEE mostly due to stent thromboses/restenoses. This feature emphasizes the advantages of more aggressive methods of revascularization over interventional.


2019 ◽  
pp. 42-48

Takayasu arteritis is a chronic, rare arteritis that causes arterial stenosis / occlusion and dilation, affects the aorta and its branches. The most commonly affected branches are the subclavian artery and the common carotid artery. It is mainly diagnosed in women under 40 years of age. It is most commonly observed in Japan, Southeast Asia, India and Mexico. We represent a clinical case of a patient with Takayasu arteritis, with diagnosed significant stenosis of the common carotid arteries and subclavian artery. Doppler sonography was used for screening. Endovascular treatment of lesions with different localization has been applied in stages. They have been successfully and effectively treated by implanting different types of stent on the Takayasu-affected artery lesions. No intra-procedural major events were observed, as well as death or severe complications during the follow-up.


2017 ◽  
Vol 31 (3) ◽  
pp. 305-308 ◽  
Author(s):  
Akira Uchino ◽  
Kazuhiko Uwabe ◽  
Iichiro Osawa

Rarely, the external and internal carotid arteries arise separately from the brachiocephalic trunk and right subclavian artery (SA) or the aortic arch and reflect the absence of a common carotid artery (CCA). We report a 45-year-old man with absent right CCA associated with aberrant right SA, an extremely rare combination, diagnosed by computed tomography (CT) angiography during follow-up for postoperative aortic dissection. Retrospective careful observation of preoperative postcontrast CT revealed the absent right CCA. Previously reported arch variations associated with absent CCA include cervical aortic arch, double aortic arch, and right aortic arch.


Author(s):  
Novikova I.N. ◽  
Popova T.F. ◽  
Gribacheva I.A. ◽  
Petrova E.V. ◽  
Marushchak A.A. ◽  
...  

Moya-Moya disease is a rare progressive chronic cer-ebrovascular disease characterized by a narrowing of the lumen of the intracranial segments of the internal carotid arteries, as well as the initial segments of the anterior and middle cerebral arteries with the devel-opment of a network of small vascular anastomoses. Violations of blood supply due to occlusion lead to the development of ischemic strokes in the correspond-ing pools, and ruptures of vascular anastomoses - to the development of hemorrhagic strokes, causing a variety of neurological disorders. The article presents a clinical case of Moya-Moya disease in a 31-year-old patient. The disease was manifested by acute disorders of cerebral circulation in ischemic and hemorrhagic types. The diagnosis was made in accordance with the diagnostic criteria of the disease based on the data of endovascular cerebral angiography.


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