scholarly journals Research into in-stent intimal hyperplasia of carotid artery stenting followed by carotid duplex ultrasound

Neurosonology ◽  
2016 ◽  
Vol 29 (2) ◽  
pp. 89-94
Author(s):  
Fumio NAKAGAWA ◽  
Hidemasa NAGAI ◽  
Takeshi MIYAZAKI ◽  
Masahiro TSUJI ◽  
Hirotake EDA ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Intimal Hyperplasia ◽  
Carotid Artery Stenting ◽  
Duplex Ultrasound ◽  
Carotid Duplex

scholarly journals Optimization of duplex velocity criteria for diagnosis of internal carotid artery (ICA) stenosis: A report of the Intersocietal Accreditation Commission (IAC) Vascular Testing Division Carotid Diagnostic Criteria Committee

2021 ◽  
pp. 1358863X2110112
Author(s):  
Heather L Gornik ◽  
Tatjana Rundek ◽  
Hannah Gardener ◽  
James F Benenati ◽  
Nirvikar Dahiya ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Diagnostic Criteria ◽  
Internal Carotid ◽  
Peak Systolic Velocity ◽  
Duplex Ultrasound ◽  
Additional Parameter ◽  
Characteristic Analysis ◽  
Carotid Duplex ◽  
Ica Stenosis

Diagnostic criteria to classify severity of internal carotid artery (ICA) stenosis vary across vascular laboratories. Consensus-based criteria, proposed by the Society of Radiologists in Ultrasound in 2003 (SRUCC), have been broadly implemented but have not been adequately validated. We conducted a multicentered, retrospective correlative imaging study of duplex ultrasound versus catheter angiography for evaluation of severity of ICA stenosis. Velocity data were abstracted from bilateral duplex studies performed between 1/1/2009 and 12/31/2015 and studies were interpreted using SRUCC. Percentage ICA stenosis was determined using North American Symptomatic Carotid Endarterectomy Trial (NASCET) methodology. Receiver operating characteristic analysis evaluated the performance of SRUCC parameters compared with angiography. Of 448 ICA sides (from 224 patients), 299 ICA sides (from 167 patients) were included. Agreement between duplex ultrasound and angiography was moderate (κ = 0.42), with overestimation of degree of stenosis for both moderate (50–69%) and severe (⩾ 70%) ICA lesions. The primary SRUCC parameter for ⩾ 50% ICA stenosis of peak-systolic velocity (PSV) of ⩾ 125 cm/sec did not meet prespecified thresholds for adequate sensitivity, specificity, and accuracy (sensitivity 97.8%, specificity 64.2%, accuracy 74.5%). Test performance was improved by raising the PSV threshold to ⩾ 180 cm/sec (sensitivity 93.3%, specificity 81.6%, accuracy 85.2%) or by adding the additional parameter of ICA/common carotid artery (CCA) PSV ratio ⩾ 2.0 (sensitivity 94.3%, specificity 84.3%, accuracy 87.4%). For ⩾ 70% ICA stenosis, analysis was limited by a low number of cases with angiographically severe disease. Interpretation of carotid duplex examinations using SRUCC resulted in significant overestimation of severity of ICA stenosis when compared with angiography; raising the PSV threshold for ⩾ 50% ICA stenosis to ⩾ 180 cm/sec as a single parameter or requiring the ICA/CCA PSV ratio ⩾ 2.0 in addition to PSV of ⩾ 125 cm/sec for laboratories using the SRUCC is recommended to improve the accuracy of carotid duplex examinations.

scholarly journals Trends in Postoperative Carotid Duplex Surveillance Ultrasound After Carotid Artery Stenting

2020 ◽  
Vol 72 (1) ◽  
pp. e106
Author(s):  
Nathan Belkin ◽  
Alex Fairman ◽  
Scott Damrauer ◽  
Benjamin M. Jackson ◽  
Paul J. Foley ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Carotid Duplex

Management of Mobile Floating Carotid Plaque Using Carotid Artery Stenting

2003 ◽  
Vol 10 (3) ◽  
pp. 653-656 ◽  
Author(s):  
Elie Y. Chakhtoura ◽  
Jonathan E. Goldstein ◽  
Robert W. Hobson
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Carotid Plaque ◽  
Case Reports ◽  
Duplex Ultrasound ◽  
Carotid Stenting ◽  
Clinical Results ◽  
Unique Nature ◽  
Risk Patients ◽  
Ischemic Attack

Purpose: To present management techniques for dealing with mobile floating carotid plaque (MFCP), which represents an indeterminate risk of embolic cerebrovascular events. Case Reports: Two high-risk patients with a history of carotid endarterectomy were diagnosed with MFCP by duplex ultrasound scanning. One patient had a left hemispheric transient ischemic attack while the other was asymptomatic with a moderate stenosis. Both were successfully treated with carotid artery stenting, achieving complete coverage of the MFCP. Their outcomes were uneventful, and sustained patency of the stented arteries has been observed during an event-free survival of 32 and 44 months, respectively. Conclusions: Based upon the unique nature of these lesions and our satisfactory clinical results, we believe that carotid stenting may be a viable option for the treatment of MFCP.

Intravascular Lithotripsy for Treatment of Calcified Lesions During Carotid Artery Stenting

2020 ◽  
pp. 152660282095424
Author(s):  
Stefanos Giannopoulos ◽  
Francesco Speziale ◽  
Giuseppe Vadalà ◽  
Peter Soukas ◽  
Brian A. Kuhn ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
De Novo ◽  
Duplex Ultrasound ◽  
Carotid Artery Lesions ◽  
Risk Patients ◽  
History Of ◽  
Protection Devices ◽  
The Mean ◽  
Symptomatic Bradycardia

Purpose: To report the use of intravascular lithotripsy (IVL) in the treatment of calcified carotid artery lesions. Materials and Methods: The records of 21 high-surgical-risk patients (mean age 75.1±8.1 years; 17 men) who were treated at 8 centers for carotid artery stenosis ≥70% were retrospectively reviewed. Twelve patients had a history of cerebrovascular disease. All patients had heavily calcified carotid artery lesions: 19 de novo and 2 in-stent restenoses (ISR). The mean baseline stenosis was 82.3%±9.7%. IVL was utilized at the discretion of the operator, followed by balloon angioplasty. Embolic protection devices were used in all cases. Results: In 19 patients, IVL was followed by stent implantation; the 2 ISR lesions were dilated only. The mean IVL balloon diameter was 4.64±1.13 mm, and the mean number of IVL pulses applied was 67.2±61.4 (range 10–180). All procedures were technically successful (<30% residual stenosis). No patients developed symptomatic bradycardia or hypotension due to IVL, and there were no adverse events associated with IVL delivery. All patients were discharged on dual antiplatelet therapy. Seventeen days after the procedure, 1 patient experienced an ischemic stroke that was deemed due to aortic arch manipulation during transfemoral access. Carotid duplex ultrasound examination identified significant restenosis (>70%) in 1 asymptomatic patient at 12 months after the index procedure. No patients required reintervention during a median follow-up of 6 months (range 1–12). Conclusion: This preliminary experience demonstrates that IVL can be a safe and effective approach for the management of severely calcified carotid lesions. Further research is warranted to determine the longer-term safety and efficacy of IVL for dilation of calcified carotid artery lesions as an adjunct to carotid artery stenting.

scholarly journals Trends in Postoperative Carotid Duplex Surveillance Ultrasound After Carotid Artery Stenting

2021 ◽  
Vol 74 (3) ◽  
pp. e241-e242
Author(s):  
Nathan Belkin ◽  
Scott Damrauer ◽  
Benjamin Jackson ◽  
Julia Glaser ◽  
Venkat Kalapatapu ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Carotid Duplex

scholarly journals Mobility of an in-stent plaque protrusion detected with carotid duplex during the carotid artery stenting procedure: a case report

2019 ◽  
Vol 21 (1) ◽  
pp. 89 ◽  
Author(s):  
Kanta Tanaka ◽  
Takamichi Kitagawa ◽  
Norikazu Yamana ◽  
Yoshinori Akiyama
Keyword(s):  
Case Report ◽  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Risk Estimation ◽  
Distal Embolization ◽  
Stent Deployment ◽  
Potential Value ◽  
Carotid Duplex ◽  
Ischemic Complications ◽  
Stenting Procedure

In-stent plaque protrusion (ISP) is a predictor for ischemic complications in carotid artery stenting (CAS). Because its mobility would further increase the distal embolization risk, the intraprocedural detection of mobility is important but has not yet been reported. We present an 87-year-old male with symptomatic right carotid artery stenosis who underwent CAS. Intravascular ultrasound (IVUS) after stent deployment revealed a small ISP, and simultaneous extravascular carotid duplex disclosed its mobility. After coverage of the ISP with stent-in-stent implantation, no remaining protrusion was observed with either IVUS or carotid duplex. The patient experienced no periprocedural strokes. Carotid duplex is suited to evaluate targets’ movement because of its excellent temporal resolution. Carotid duplex has potential value for intraprocedural risk estimation of ISP.

scholarly journals Carotid Artery Stenting Successfully Prevents Progressive Stroke Due to Mobile Plaque

2015 ◽  
Vol 7 (2) ◽  
pp. 121-126 ◽  
Author(s):  
Masahiro Oomura ◽  
Chikako Sato ◽  
Kentaro Yamada ◽  
Toshimasa Ikeda ◽  
Chise Anan ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Carotid Artery ◽  
Medical Therapy ◽  
Common Carotid Artery ◽  
Carotid Artery Stenting ◽  
Right Hemisphere ◽  
Duplex Ultrasound ◽  
Closed Cell ◽  
Maximal Medical Therapy ◽  
The Right

We report a case of progressive ischemic stroke due to a mobile plaque, in which carotid artery stenting successfully prevented further infarctions. A 78-year-old man developed acute multiple infarcts in the right hemisphere, and a duplex ultrasound showed a mobile plaque involving the bifurcation of the left common carotid artery. Maximal medical therapy failed to prevent further infarcts, and the number of infarcts increased with his neurological deterioration. Our present case suggests that the deployment of a closed-cell stent is effective to prevent the progression of the ischemic stroke due to the mobile plaque.

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