scholarly journals Endovascular Repair of Radiation-induced Bilateral Common Carotid Artery Stenosis and Pseudoaneurysm with Covered and Uncovered Stent Graft using Double Embolic Protection Device

2021 ◽  
Vol 6 (1) ◽  
pp. 1-4
Author(s):  
Javier Rodriguez-Padilla ◽  
Keyword(s):  
Carotid Artery ◽  
Common Carotid Artery ◽  
Protection Device ◽  
Embolic Protection Device ◽  
Embolic Protection ◽  
Critical Stenosis ◽  
Bilateral Carotid ◽  
Radiation Induced ◽  
The Right ◽  
Uncovered Stent

Purpose: We present an unpublished case of bilateral carotid injury due to radiation-induced treated by endovascular therapy using double embolic protection device as a novel technique. Methods: Extracranial carotid artery pseudoaneurysm is a rare condition among head and neck cancer patients treated with radio therapy. We report a case of pseudoaneurysm in the right Common Carotid Artery (CCA) and critical stenosis in the left CCA. A 72 years-old patient laryngeal cancer treated with laryngectomy and radiotherapy 26 years before admission. He presented to us complaining of right neck pain and right hemispheric TIA symptoms. Results: Performed ultrasonography and magnetic resonance angiography revealed right Common Carotid Artery (CCA) pseudoaneurysm (size:13x25 mm) and critical stenosis in the left CCA. Endovascular treatment was performed in bilateral carotid artery using covered stent in pseudoaneurysms in the right CCA and uncovered stent due critical stenosis in the left CCA using double embolic protection device. Both procedures showed successful exclusion of the pseudoaneurysm and widely patent artery. Conclusion: Endovascular treatment in injury artery radiation-induced is safe and effective approach with low rate complications. The combined use of proximal cerebral protection devices and distal filter protection could decrease the rate of cerebral embolization procedure related.

scholarly journals A case of tandem stenoses at the proximal common and internal carotid arteries treated with transbrachial stenting: a case report

2018 ◽  
Vol 25 (2) ◽  
pp. 225-229
Author(s):  
Hidemichi Ito ◽  
Masashi Uchida ◽  
Taigen Sase ◽  
Yuichiro Kushiro ◽  
Tetsuya Ikeda ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Common Carotid Artery ◽  
Carotid Artery Stenting ◽  
Internal Carotid ◽  
Protection Device ◽  
Embolic Protection Device ◽  
Embolic Protection ◽  
Carotid Stenoses ◽  
The Common

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.

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.

scholarly journals Traumatic Bilateral Common Carotid Artery Dissection Due to Strangulation

2006 ◽  
Vol 12 (2) ◽  
pp. 149-154 ◽  
Author(s):  
I. Chokyu ◽  
T. Tsumoto ◽  
T. Miyamoto ◽  
H. Yamaga ◽  
T. Terada ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Carotid Artery ◽  
Common Carotid Artery ◽  
Carotid Artery Dissection ◽  
Artery Dissection ◽  
Bilateral Common Carotid Artery ◽  
Bilateral Carotid ◽  
Cord Injury ◽  
The Right ◽  
Bilateral Carotid Artery

We report a case of bilateral common carotid artery dissection due to strangulation successfully treated by stent placement, with a review of the literature. A 61-year-old woman was strangled by an apron strap. She was admitted to our hospital with tetraparesis, because of spinal cord injury. On the next day, her left hemiparesis aggravated and left facial palsy newly appeared. Diffusion weighted magnetic resonance imaging (MRI) showed new ischemic lesions in the right cerebral hemisphere. Aortography revealed bilateral common carotid artery dissection. Moreover, thrombus or intimal flap was recognized in the right common carotid artery. The right common carotid dissection was fixed with deployment of self expanding stents to prevent the aggravation of ischemic stroke at that time. The contralateral lesion was also treated ten days later because small ischemic lesions were newly recognized in the left hemisphere on MRI. No new neurological deficit appeared after bilateral carotid artery stenting. Her paraparesis completely improved two months after the spinal cord injury. Carotid artery stenting using self expanding stents was especially effective as the treatment for bilateral carotid artery dissection.

scholarly journals Percutaneous Angioplasty of the Sole Patent Cerebral Artery in Two Patients with Takayasu's Aortoarteritis

2016 ◽  
Vol 10 ◽  
pp. CMC.S38329
Author(s):  
Kiron Varghese ◽  
Srilakshmi M. Adhyapak
Keyword(s):  
Carotid Artery ◽  
Cerebral Artery ◽  
Balloon Angioplasty ◽  
Common Carotid Artery ◽  
Critical Stenosis ◽  
Neurological Event ◽  
Protection Devices ◽  
Distal Protection ◽  
The Right

We report two female patients with Takayasu's aortoarteritis, who presented with symptoms of cerebral ischemia due to critical stenosis of the sole patent cerebral artery. Both had occlusion of both vertebral arteries and one carotid artery with critical stenosis of the other carotid artery and presented with hemiparesis contralateral to the patent but stenosed cerebral artery. They also had transient ischemic attacks attributable to the culprit vessel. In the first patient, balloon angioplasty alone was not successful, and hence, a self-expanding stent was deployed in the right common carotid artery. In the second patient, successful balloon angioplasty was performed for the left common carotid artery. Distal protection devices were not used, and neither patient experienced any periprocedural neurological event. Clinical follow-up at six months revealed no significant cerebral events.

FiberNet-A new embolic protection device for carotid artery stenting

2013 ◽  
Vol 83 (6) ◽  
pp. 1014-1020 ◽  
Author(s):  
C. Bauer ◽  
J. Franke ◽  
S.C. Bertog ◽  
V. Woerner ◽  
S. Ghasemzadeh-Asl ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Protection Device ◽  
Embolic Protection Device ◽  
Embolic Protection

scholarly journals Letter by de Castro-Afonso et al Regarding Article, “Operator’s Experience Is the Most Efficient Embolic Protection Device for Carotid Artery Stenting”

2014 ◽  
Vol 7 (1) ◽  
pp. 130-130
Author(s):  
Luis Henrique de Castro-Afonso ◽  
Lucas Giansante Abud ◽  
Jaicer Gonçalves Rolo ◽  
Antônio Carlos dos Santos ◽  
Lívia de Oliveira ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Protection Device ◽  
Embolic Protection Device ◽  
Embolic Protection
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