Treatment options for intracranial carotid artery stenosis: what about stents?

1999 ◽  
Vol 173 (4) ◽  
pp. 1129-1130
Author(s):  
F Brassel ◽  
J Rademaker ◽  
H Becker
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenosis ◽  
Treatment Options ◽  
Artery Stenosis

The clinical application of a scoring protocol to select endarterectomy or stenting for carotid artery stenosis

2020 ◽  
Author(s):  
Joonho Chung ◽  
Jung-Jae Kim ◽  
Yong Bae Kim ◽  
Sang Hyun Suh ◽  
Kyung-Yul Lee
Keyword(s):  
Clinical Practice ◽  
Surgical Treatment ◽  
Carotid Artery ◽  
Clinical Setting ◽  
Carotid Artery Stenosis ◽  
Treatment Options ◽  
Artery Stenosis ◽  
Related Complication ◽  
Symptomatic Stenosis ◽  
Selection Of

Abstract Background Our group previously described the protocol-based decision for choosing the proper surgical treatment option for carotid artery stenosis. The objective of this study is to describe our experiences of using this scoring protocol in the selection of endarterectomy or stenting for carotid artery stenosis. Methods Between October 2014 and March 2018, the scoring protocol was applied to a total of 105 consecutive patients. Eighty (76.2%) patients had symptomatic stenosis ≥50%, and 25 (23.8%) patients had asymptomatic stenosis ≥80%. We also speculated about how effectively the protocol worked in the real clinical setting. Results Stenting was performed in 73 patients and endarterectomy in 32 patients. Overall, 98 (93.3%) patients were treated according to the protocol, while the protocol was violated in seven (6.7%) patients. Sixty-one (58.1%) patients received treatments that were decided by the protocol. There were 37 (35.2%) patients who had the same score for both treatment options. Among these patients, 28 patients underwent stenting and nine patients underwent endarterectomy. In the stenting cases, 90.4% of the patients followed the protocol and violations occurred in 9.6%. In the endarterectomy cases, all of the patients followed the protocol. Overall, one patient had a procedure-related complication without morbidity. During the 12-month follow-ups, there were no restenoses or major strokes. Minor strokes were diagnosed in three (2.8%) patients. Conclusion In patients with carotid artery stenosis, stenting and endarterectomy should be considered simultaneously together, not against each other. Our scoring protocol can be used to weigh these options and applied in clinical practice.

Strategies for asymptomatic carotid artery stenosis

2011 ◽  
Vol 31 (6) ◽  
pp. E9 ◽  
Author(s):  
Christopher Doe ◽  
Pinakin R. Jethwa ◽  
Chirag D. Gandhi ◽  
Charles J. Prestigiacomo
Keyword(s):  
Carotid Artery ◽  
Carotid Endarterectomy ◽  
Medical Management ◽  
Carotid Artery Stenosis ◽  
Treatment Options ◽  
Artery Stenosis ◽  
Carotid Angioplasty ◽  
Asymptomatic Carotid ◽  
The Past ◽  
Asymptomatic Carotid Artery Stenosis

The treatment of asymptomatic carotid artery stenosis (ACAS) has continued to evolve for the past 3 decades. With rapidly advancing technology, the results of old trials have become obsolete. While there has been little change in the efficacy of carotid endarterectomy, there have been vast improvements in both medical management and carotid angioplasty with stenting. Finding the best therapy for a given patient can therefore be difficult. In this article, the authors review the current literature regarding treatment options for ACAS and the methods available for stratifying patients who would benefit from surgical versus medical treatment.

Carotid Stenting

2021 ◽  
pp. 69-76
Author(s):  
Omaditya Khanna ◽  
Nikolaos Mouchtouris ◽  
Eric C. Peterson ◽  
Pascal M. Jabbour
Keyword(s):  
Carotid Artery ◽  
Radial Artery ◽  
Stent Placement ◽  
Carotid Artery Stenosis ◽  
Large Scale ◽  
Treatment Options ◽  
Carotid Stenting ◽  
Artery Stenosis ◽  
Carotid Artery Stent ◽  
Recovery Times

Several large-scale studies have corroborated the indications for carotid artery revascularization in patients who present with carotid artery stenosis. The two treatment options are carotid endarterectomy and carotid artery stent, both of which show equipoise in outcomes, and although the latter is associated with increased risk of periprocedural stroke, it confers the benefit of shorter procedural and recovery times. Currently, radial artery access is rarely used for placement of carotid artery stents, both among neurosurgeons and vascular surgeons. However, radial artery access for carotid stent placement has been shown to be safe and efficacious, and it confers the benefit of reduced access-site complications and improved patient satisfaction measures. In this chapter, aimed at practitioners who would like to incorporate radial artery access into their clinical practice, we review the evaluation and management of carotid artery stenosis and present an operative technique for carotid artery stent placement via radial artery access.

scholarly journals Carotid stenting in Nepal: Our experience with two cases of carotid stenosis

2021 ◽  
Vol 18 (3) ◽  
pp. 44-48
Author(s):  
Pravesh Rajbhandari ◽  
Saujanya Rajbhandari ◽  
Anish Neupane ◽  
Tariq Martin ◽  
Basant Pant
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenosis ◽  
Carotid Artery Stenting ◽  
Treatment Options ◽  
Cervical Vertebra ◽  
Carotid Stenting ◽  
Artery Stenosis ◽  
Invasive Approach ◽  
Less Invasive Approach ◽  
Distal Filter

Carotid artery stenosis is one of the important risk factors for stroke. Carotid endarterectomy and carotid artery stenting are the available treatment options for managing carotid artery stenosis patients. The technology shift towards carotid artery stenting is promising due to its less invasive approach. Carotid artery stenting has become an alternative for surgically high-risk patients and high carotid lesions (lesions located at or above the second cervical vertebra). Here, we present two cases with carotid artery stenosis who were successfully treated with open-cell type carotid stent with distal filter embolic protection device.

Oxidative injury associated with stenting of asymptomatic carotid artery stenosis

VASA ◽  
2017 ◽  
Vol 46 (4) ◽  
pp. 268-274
Author(s):  
Erhan Saraçoğlu ◽  
Ertan Vuruşkan ◽  
Yusuf Çekici ◽  
Salih Kiliç ◽  
Halil Ay ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Carotid Artery ◽  
Oxidative Damage ◽  
Carotid Artery Stenosis ◽  
Artery Stenosis ◽  
Oxidative Stress Marker ◽  
Asymptomatic Carotid ◽  
Imaging Methods ◽  
Neurological Findings ◽  
Asymptomatic Carotid Artery Stenosis

Abstract. Background: After carotid artery stenting (CAS), neurological complications that cannot be explained with imaging methods may develop. In our study we aimed to show, using oxidative stress markers, isolated oxidative damage and resulting neurological findings following CAS in patients with asymptomatic carotid artery stenosis. Patients and methods: We included 131 neurologically asymptomatic patients requiring CAS. The neurological findings were evaluated using the modified Rankin Scale (mRS) prior to the procedure, one hour post-procedure, and two days after. Patients with elevated mRS scores but with or without typical hyperintense lesions observed on an MRI and with changes of oxidative stress marker levels at the time (Δtotal-thiol, Δtotal antioxidative status [TAS], and Δtotal oxidant status [TOS]) were evaluated. Results: In the neurological examination carried out one hour prior to the procedure, there were 92 patients with mRS = 0, 20 with mRS = 1, and 12 with mRS = 2. When Δtotal-thiol, ΔTAS, and ΔTOS values and the mRS were compared, it was observed that as the difference in oxidative parameters increased, clinical deterioration also increased proportionally (p = 0.001). Conclusions: We demonstrate a possible correlation between oxidative damage and neurological findings after CAS which could not be explained by routine imaging methods.

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