scholarly journals Anatomical Risk Factors for Ischemic Lesions Associated with Carotid Artery Stenting

2014 ◽  
Vol 20 (6) ◽  
pp. 746-754 ◽  
Author(s):  
Go Ikeda ◽  
Wataro Tsuruta ◽  
Yasunobu Nakai ◽  
Masanari Shiigai ◽  
Aiki Marushima ◽  
...  

The purpose of this study was to investigate the anatomical risk factors for ischemic lesions detected by diffusion-weighted imaging (DWI) associated with carotid artery stenting (CAS). DWI was performed within four days after CAS in 50 stenotic lesions between January 2008 and September 2013. We retrospectively analyzed the correlation between the anatomical factors and ischemic lesions associated with CAS. Post-procedural DWI revealed new ischemic lesions after 24 (48%) of the 50 CAS procedures. All three patients with common carotid artery tortuosity, defined as the presence of severe angulation (less than 90 degrees) in the common carotid artery, developed new ischemic lesions. However, there were no significant differences between the patients with and without tortuosity, likely due to the small number of cases. Meanwhile, seven of eight patients with internal carotid artery tortuosity, defined as the presence of severe angulation (less than 90 degrees) in the cervical segment of the internal carotid artery, developed new ischemic lesions. A multivariate analysis showed internal carotid artery tortuosity (odds ratio: 11.84, 95% confidence interval: 1.193–117.4, P= 0.035) to be an independent risk factor for the development of ischemic lesions associated with CAS. Anatomical factors, particularly severe angulation of the internal carotid artery, have an impact on the risk of CAS. The indications for CAS should be carefully evaluated in patients with these factors.

2012 ◽  
Vol 18 (3) ◽  
pp. 320-325 ◽  
Author(s):  
S. Toyota ◽  
A. Wakayama ◽  
T. Yoshimine

A 54-year-old man with symptomatic internal carotid artery stenosis with absence of the common carotid artery (CCA), who had been treated with surgery and postoperative radiotherapy for tonsillar carcinoma, underwent direct percutaneous carotid artery stenting (CAS). To our knowledge, this is the first report of direct percutaneous carotid artery stenting (CAS) for a patient with absent CCA.


2016 ◽  
Vol 38 (05) ◽  
pp. 523-529 ◽  
Author(s):  
Jeire Steinbuch ◽  
Anouk van Dijk ◽  
Floris Schreuder ◽  
Martine Truijman ◽  
Alexandra de Rotte ◽  
...  

Abstract Purpose Inhomogeneity of arterial wall thickness may be indicative of distal plaques. This study investigates the intra-subject association between relative spatial intima-media thickness (IMT) inhomogeneity of the common carotid artery (CCA) and the degree of stenosis of plaques in the internal carotid artery (ICA). Materials and Methods We included 240 patients with a recent ischemic stroke or transient ischemic attack and mild-to-moderate stenosis in the ipsilateral ICA. IMT inhomogeneity was extracted from B-mode ultrasound recordings. The degree of ICA stenosis was assessed on CT angiography according to the European Carotid Surgery Trial method. Patients were divided into groups with a low (≤ 2 %) and a high (> 2 %) IMT inhomogeneity scaled with respect to the local end-diastolic diameter. Results 182 patients had suitable CT and ultrasound measurements. Relative CCA-IMT inhomogeneity was similar for the symptomatic and asymptomatic side (difference: 0.02 %, p = 0.85). High relative IMT inhomogeneity was associated with a larger IMT (difference: 235 µm, p < 0.001) and larger degree of ICA stenosis (difference: 5 %, p = 0.023) which remained significant (p = 0.016) after adjustment for common risk factors. Conclusion Regardless of common risk factors, high relative CCA-IMT inhomogeneity is associated with a greater degree of ICA stenosis and is therefore indicative of atherosclerotic disease. The predictive value of CCA-IMT inhomogeneity for plaque progression and recurrence of cerebrovascular symptoms will be determined in the follow-up phase of PARISK.


2018 ◽  
Vol 25 (2) ◽  
pp. 225-229
Author(s):  
Hidemichi Ito ◽  
Masashi Uchida ◽  
Taigen Sase ◽  
Yuichiro Kushiro ◽  
Tetsuya Ikeda ◽  
...  

The transfemoral approach is a common technique for carotid artery stenting. However, it has the risk of distal embolism when stenting for a stenosis of the proximal common carotid artery because of poor stability of the guiding catheter resulting in difficulty in setting the embolic protection device prior to stenting. We present a novel therapeutic approach and technique for the treatment of tandem carotid stenoses including the proximal common carotid artery. A 63-year-old man presented with double stenoses at the common carotid artery and internal carotid artery. We used a transbrachial sheath guide that had a 6 Fr (2.24 mm, 0.088 inch) internal diameter and was 90 cm long, and was specifically designed for direct cannulation to the common carotid artery, like a modified Simmons catheter. Because the sheath guide positioned in the aortic arch made it possible to introduce safely the embolic protection device distal to the internal carotid artery stenosis without touching the plaque at the stenosis with no use of any coaxial catheters or guidewires, carotid artery stenting for tandem stenoses could be successfully carried out. The postoperative course was uneventful. In carotid artery stenting, especially for stenosis of the proximal common carotid artery, the sheath guide designed for transbrachial carotid cannulation was useful in stenting the tandem carotid stenoses.


1991 ◽  
Vol 32 (6) ◽  
pp. 488-491 ◽  
Author(s):  
P. N. Jayakumar ◽  
B. Y. T. Arya ◽  
M. K. Vasudev

The cerebral angiograms of 8 patients with childhood moyamoya disease showed that the common findings were stenosis/occlusion of the supraclinoid internal carotid artery and the proximal segments of the anterior and middle cerebral arteries and basal moyamoya. The volume of basal moyamoya and its collateral supply depended upon the stage of the disease. Leptomeningeal collaterals were frequent in the later stages. Stenotic lesions in the posterior circulation were seen in a majority (75%) of patients. A feature unique to the study was evidence of intracranial small-vessel disease and stenotic cervical internal carotid artery in half of the cases. The disease in the ethnic caucasian Indians seems largely similar to the classical disease frequently reported in the Japanese literature.


2021 ◽  
Vol 8 (9) ◽  
pp. 1274
Author(s):  
Magaji G. Ojaare ◽  
Terkimbi I. Annongu ◽  
Chia D. Msuega ◽  
Hameed O. Mohammad ◽  
Abubakar Farati ◽  
...  

Background: Carotid artery dimensions are increasingly used for detecting early atherosclerosis and predicting clinical complications. Aim was to explore relationships between gender, age and body mass index (BMI) and the diameters of the common carotid artery (CCA) and internal carotid artery (ICA) using ultrasonography.Methods: This was a cross-sectional study carried out at the University of Maiduguri Teaching Hospital between February-October, 2011. The 400 adult males and females above 18 years underwent carotid artery ultrasonography for measurement of the IMT of the common and internal carotid arteries. The influence of age, sex, weight, height, and the basal metabolic index (BMI) was investigated.Results: There were 239 (59.80%) males and 161 (40.20%) females aged between 18 to 81 years (Mean±SD, 36.74±14.79 years). The mean±SD diameters for right common carotid artery (RCCA) and left common carotid artery (LCCA) were 6.39±0.71mm and 6.28±0.74mm respectively. The right internal carotid artery (RICA) and left internal carotid artery (LICA) had mean±SD diameters of 4.63±0.63 mm and 4.61±0.63 mm respectively. The luminal diameters of the carotid arteries increased significantly with age and increased BMI. The luminal diameters of the CCA and ICA were significantly smaller in women than in men.Conclusions: Common carotid and internal carotid artery luminal diameter tends to be larger in men than women among adults and increases with age and BMI. There is no difference in the luminal diameter between the left and right carotid artery. 


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