scholarly journals Carotid Artery Stenting

Neurology ◽  
2021 ◽  
Vol 97 (20 Supplement 2) ◽  
pp. S137-S144
Author(s):  
Alhamza R. Al-Bayati ◽  
Raul G. Nogueira ◽  
Diogo C. Haussen
Keyword(s):  
Ischemic Stroke ◽  
Cerebral Ischemia ◽  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Preventive Measures ◽  
Treatment Strategies ◽  
Carotid Disease ◽  
Close Inspection ◽  
Cerebrovascular Imaging

Purpose of The ReviewTo examine current understanding of diverse etiologies of extracranial carotid disease, including clinical and imaging manifestations as well as treatment approaches.Recent FindingsIncreasing availability of advanced cerebrovascular imaging modalities continues to elucidate atherosclerotic and nonatherosclerotic carotid steno-occlusive disease as a common culprit of cerebral ischemia. Individualized treatment strategies targeting each etiologic subset would optimize preventive measures and minimize recurrence of cerebral ischemia.SummaryIschemic stroke is a prominent cause of mortality and long-term disability worldwide. The magnified effect of carotid disease warrants constant and close inspection.

scholarly journals Revascularization of acute stent thrombosis after carotid artery stenting in a CYP2C19*2 heterozygote patient

2021 ◽  
Vol 49 (3) ◽  
pp. 030006052110011
Author(s):  
Wei Wei ◽  
Yan Wang ◽  
Pian Wang ◽  
Zheng Li
Keyword(s):  
Ischemic Stroke ◽  
Carotid Artery ◽  
Carotid Endarterectomy ◽  
Stent Thrombosis ◽  
Carotid Artery Stenting ◽  
Rare Event ◽  
Treatment Strategies ◽  
Carotid Stent ◽  
Appropriate Treatment ◽  
Acute Stent Thrombosis

Carotid artery stenting (CAS) is an alternative strategy to carotid endarterectomy for the prevention of ischemic stroke. Acute carotid stent thrombosis (ACST) is an extremely rare but devastating complication of CAS. Although cases of successful recanalization have been reported, there is still a lack of experience regarding the choice of ACST treatment methods and the timing of such treatments, especially when patients are confirmed CYP2C19*2 heterozygotes. Here, we report a case of successful revascularization after ACST in a patient with CYP2C19*2 heterozygosity. We also review the literature and discuss appropriate treatment strategies for this devastating and rare event.

Successful carotid artery stenting in patients with aortic dissection

2020 ◽  
Keyword(s):  
Ischemic Stroke ◽  
Carotid Artery ◽  
Aortic Dissection ◽  
Cerebral Infarction ◽  
Acute Ischemic Stroke ◽  
Aortic Arch ◽  
Common Carotid Artery ◽  
Carotid Artery Stenting ◽  
Acute Aortic Dissection ◽  
Optimal Timing

Background: There are no guidelines for the optimal timing of surgery (emergency vs. delayed) for ascending aortic dissection with acute ischemic stroke. We retrospectively compared the prognoses and radiological and clinical findings for concomitant aortic dissection and ischemic stroke in a series of case reports. Case presentation: Three patients presented with left hemiparesis. Patient 1 underwent surgery for acute aortic dissection without treatment for acute ischemic stroke. In Patient 2, emergency stenting could not be performed due to cardiac tamponade and hypotension. Therefore, emergency acute aortic dissection surgery was performed. Patient 3 underwent emergency right common carotid artery stenting followed by surgery for acute aortic dissection. Brain perfusion computed tomography angiography (CTA) was performed to diagnose severe stenosis of the right common carotid artery or occlusion concomitant with acute aortic dissection involving the aortic arch with a cerebral perfusion mismatch in all the patients. Patient 3 had postoperative local cerebral infarction, whereas patients 1 and 2 (without stent insertion) had extensive postoperative cerebral infarction. Conclusion: Patient 3 showed a better prognosis than patients without stent treatment. We suggest that perfusion CTA of the aortic arch in suspected acute ischemic stroke can facilitate early diagnosis and prompt treatment in similar patients.

scholarly journals Long-Term Results of Carotid Artery Stenting in Veterans With Prior Head and Neck Cancer

2017 ◽  
Vol 66 (4) ◽  
pp. e91-e92
Author(s):  
Roy W. Jones ◽  
Adam Tanious ◽  
Paul Armstrong ◽  
Neil Moudgill ◽  
Karl A. Illig ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Carotid Artery ◽  
Head And Neck ◽  
Neck Cancer ◽  
Carotid Artery Stenting ◽  
Long Term Results

COULD GENDER IMPACT ON IMMEDIATE AND LONG-TERM CAROTID ARTERY STENTING OUTCOME? INSIGHT FROM AN ITALIAN SINGLE CENTER EXPERIENCE

2021 ◽  
Author(s):  
Federica Fornelli ◽  
Pasqualino Sirignano ◽  
Wassim Mansour ◽  
Laura Capoccia ◽  
Simone Cuozzo ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Single Center ◽  
Single Center Experience

Abstract P540: Safety of Carotid Artery Stenting Without Embolic Protection: A Single Centre Experience

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Christine Hawkes ◽  
Aviraj Deshmukh ◽  
Brian van Adel
Keyword(s):  
Ischemic Stroke ◽  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Atheromatous Plaque ◽  
Stroke Rate ◽  
Protection Device ◽  
Single Centre ◽  
Stent Occlusion ◽  
Embolic Protection Device ◽  
Embolic Protection

Introduction: One of the most feared complications of carotid revascularization, including carotid artery stenting (CAS), is peri-procedural ischemic stroke. Several studies suggest that the use of a distal embolic protection device (EPD), as well as over-sized pre- and post-stenting balloon angioplasty, may increase the risk of dislodgement of atheromatous plaque in patients undergoing CAS. The CREST trial, that mandated the use of an EPD, had a peri-procedural ischemic stroke rate of 4.1%. We hypothesize that our technique of stenting without the use of an EPD and sub-maximal angioplasty will have a low risk of peri-procedural complications. Methods: A retrospective review was conducted of consecutive cases of ICA stenting without use of an embolic protection device between January 2012 and June 2020 at a Canadian stroke centre. Data was extracted from the patient electronic medical record and Picture Archives and Communications Systems (PACS). Both symptomatic and asymptomatic CAS cases were included. Results: A total of 220 patients were included in the study, with a median age of 70 years (range 39-93 years), and 83 patients (38%) were female. The vast majority of patients were symptomatic (216 patients [98%]). A large portion of patients had a contralateral ICA occlusion or near occlusion (56 patients [25%]). In the majority of cases, a Precise Cordis RX carotid stent (Cordis) was placed. There were four patients with peri-procedural ischemic strokes (1.8%), with two occurring 8-30 days after stenting. There was one case of acute stent occlusion associated with an ischemic stroke. Two patients (less than 1%) had hyperperfusion syndrome after CAS. Median length of stay following the procedure was one day. Conclusions: In this single centre series, the peri-procedural risks of CAS without using an EPD are low. The ischemic stroke rate is less than 2%, lower than what has been reported in large randomized controlled trials using embolic protection.

Risk factors for hyperperfusion-induced intracranial hemorrhage after carotid artery stenting in patients with symptomatic severe carotid stenosis evaluation

2018 ◽  
Vol 11 (5) ◽  
pp. 474-478 ◽  
Author(s):  
Lei Zhang ◽  
Dongwei Dai ◽  
Zifu Li ◽  
Guoli Duan ◽  
Yong-wei Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Carotid Artery ◽  
Carotid Stenosis ◽  
Intracranial Hemorrhage ◽  
Carotid Artery Stenting ◽  
Ct Perfusion ◽  
Treatment Strategies ◽  
Imaging Features ◽  
Anterior Circulation ◽  
Total Occlusion

BackgroundAnalyzing risk factors for hyperperfusion-induced intracranial hemorrhage (HICH) after carotid artery stenting (CAS) in patients with symptomatic severe carotid stenosis.MethodsThis study retrospectively analyzed clinical data of 210 patients, who had symptomatic severe carotid stenosis (70–99%) and received CAS treatment between June 2009 and June 2015, and evaluated the relationship of HICH with patients’ clinical baseline data, imaging features, and treatment strategies.ResultsSeven patients (3.3%) developed HICH after CAS. The incidence of HICH among patients with near total occlusion was significantly higher than among those without (10.1% vs 0%, P<0.001). Out of the seven, five had no development of either anterior or posterior circulations, and two had no development of anterior circulation and poor development of posterior circulation. Results showed that patients with poor compensation of Willis’ Circle were more likely to develop HICH compared with other patients (P<0.001). All patients received preoperative CT perfusion. TTP index was defined as the TTP ratio between the affected and contralateral side. The results showed that the TTP index was significantly different between the HICH group and non-HICH group (1.15±0.10 vs 1.30±0.15, P<0.001). An analysis of the ROC curve indicated that patients with TTP index >1.22 were more likely to develop HICH compared with other patients (sensitivity 100%, specificity 75.9%).ConclusionsPatients with severe unilateral carotid stenosis, the presence of near total occlusion, poor compensation of Willis’ Circle, and preoperative TTP index>1.22, have a higher risk of developing HICH after CAS.

scholarly journals Is carotid sonography a useful tool for predicting functional capabilities in ischemic stroke patients following carotid artery stenting?

Medicine ◽  
2017 ◽  
Vol 96 (12) ◽  
pp. e6363
Author(s):  
Chih-Ming Lin ◽  
Jian-Chi Su ◽  
Yu-Jun Chang ◽  
Chi-Kuang Liu ◽  
Henry Horng-Shing Lu ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Stroke Patients ◽  
Functional Capabilities

scholarly journals Carotid Artery Stenting to Prevent Stroke in a Patient with Bilateral Extracranial Internal Carotid Dissection and Vasospasm following Rupture of an Intracranial Aneurysm

2003 ◽  
Vol 9 (3) ◽  
pp. 305-310 ◽  
Author(s):  
J. Sedat ◽  
M. Dib ◽  
J. Szapiro ◽  
P. Paquis
Keyword(s):  
Cerebral Ischemia ◽  
Carotid Artery ◽  
Intracranial Aneurysm ◽  
Carotid Artery Stenting ◽  
Internal Carotid ◽  
Anticoagulation Therapy ◽  
Clinical Grade ◽  
Carotid Dissection ◽  
Aneurysmal Rupture ◽  
Therapeutic Anticoagulation

The stenting of carotid dissection has been described for the prevention of cerebral ischemia in patients who remain symptomatic despite therapeutic anticoagulation, in those who present contraindications for anticoagulation therapy, or who present a local or extensive stenosis, with an associated pseudoaneurysm. We here report a case associating a high clinical grade aneurysmal rupture with a bilateral extracranial carotid dissection. Because of the haemodynamic risk due to the acute bilateral stenosis-induced dissection and the occurrence of a vasospasm, the carotid dissections were treated with self-expendable stents.

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