Endovascular revascularization of carotid artery stenosis

Introduction. Endovascular revascularization is a peripheral artery disease therapy used to improve blood flow in blood vessels. The objective of this study was to analyze the types and prevalence of comorbidities in patients with indications for carotid artery revascularization, as well as early results of endovascular carotid artery revascularization in relation to periprocedural complications. Material and Methods. This retrospective study was conducted from October 2014 to October 2019 and included 96 patients. Descriptive and comparative statistical analysis was performed in all patients, male and female, and those with both symptomatic and asymptomatic carotid diseases. Results. The study included 96 patients, of whom 69.8% were male and 30.2% were female. A successful endovascular procedure was performed in 89.6% of patients, while in 10.4% of patients the procedure failed. The distribution of patients by sex, age and the duration of procedure, showed a statistically significant difference (p < 0.05) in the age (p = 0.0003) and duration of the procedure (p = 0.022). The comparison of two groups of patients, with symptomatic and asymptomatic carotid atherosclerotic disease, hyperlipoproteinemia (p = 0.015) showed a statistically significant difference (p < 0.05) between the two groups. Conclusion. Endovascular revascularization has a high success rate in the treatment of atherosclerotic disease of the carotid arteries as well as low periprocedural morbidity and mortality. The analysis of gender-related differences, we concluded that endovascular revascularization lasts significantly longer in female patients, and that the average age is significantly higher in male patients compared to females. We also concluded that hyperlipoproteinemia is a major risk factor for carotid artery disease.

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Screening Recommendations for Asymptomatic Carotid Artery Disease and Role of Carotid Intima-Media Thickness Evaluation: A Literature Review

Journal of Indonesian Society for Vascular and Endovascular Surgery ◽

10.36864/jinasvs.2021.1.010 ◽

2021 ◽

Vol 2 (1) ◽

pp. 34-40

Author(s):

Dedy Pratama ◽

Fajar Satria Rahmaditya

Keyword(s):

Carotid Artery ◽

Literature Review ◽

Carotid Artery Disease ◽

Intima Media Thickness ◽

Atherosclerotic Disease ◽

Asymptomatic Carotid ◽

Media Thickness ◽

Ultrasound Evaluation ◽

Artery Disease ◽

Current Guidelines

Background: Asymptomatic carotid artery disease should be treated as soon as possible before the atherosclerotic disease progressed into ischaemic stroke. Diagnostic screening by measuring intima-media thickness (IMT) of carotid artery using ultrasound is one possible way to evaluate earlier the progression compared to standard stenosis evaluation. Not only the necessity of carotid screening is still questioned by some experts, current guidelines also show conflicting results in certainty whether we should perform the carotid screening or not. It is necessary to conduct a literature review of relevant recommendations from the latest clinical practice guidelines (CPGs). Method: The CPGs on the management of asymptomatic carotid artery disease published before October 2020 were retrieved from online databases and the rigor of guideline development assesed by using the Appraisal of Guidelines Research and Evaluation II (AGREE-II) instrument. The quality of CPGs was assessed and categorized, and their reported evidences were also evaluated. Results: Six eligible CPGs were included. Five of the CPGs recommends carotid screening for highly selective patient who has morbidity regarding atherosclerotic disease manifested in other organs. One CPG against the screening as further treatment considered cause more harms, although the recommendations mainly based on hypothetical outcomes and the CPG itself categorized into moderate quality. Conclusion: Our critical review on those CPGs showed that screening for asymptomatic carotid artery disease should be performed for specific high-risk populations of atherosclerotic disease. Although IMT evaluation could be a promising technique, current guidelines didn’t show any recommendation regarding the usage comparing standard ultrasound evaluation.

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The association of the circle of Willis anomaly and risk of stroke in patients with carotid artery disease

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20170054 ◽

2017 ◽

Vol 75 (7) ◽

pp. 429-432 ◽

Cited By ~ 3

Author(s):

Eylem Özaydın Göksu ◽

Pınar Koç ◽

Elif Küçükseymen ◽

Ali Ünal ◽

Fatma Genç ◽

...

Keyword(s):

Retrospective Study ◽

Carotid Artery ◽

Carotid Artery Disease ◽

Brain Perfusion ◽

Circle Of Willis ◽

Asymptomatic Carotid ◽

Significant Difference ◽

Artery Disease ◽

Stenotic Area ◽

Collateral System

ABSTRACT The circle of Willis is an important collateral system that maintains perfusion to the stenotic area from the contralateral carotid and basilar artery to the region of reduced brain perfusion. The aim of the present study was to compare the circle of Willis anomaly in patients with unilateral symptomatic and asymptomatic carotid artery disease. Results In this retrospective study, we analyzed 175 patients who presented at our outpatient stroke clinic between January, 2013 and June, 2015 with either unilateral symptomatic or asymptomatic carotid artery disease, and who had had CT angiography imaging performed. Demographic properties, carotid artery stenosis and the anomaly of the circle of Willis was recorded. Conclusion There was no statistically significant difference in patients with symptomatic and asymptomatic carotid artery disease in terms of the anomaly of the circle of Willis.

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