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.

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.

Endovascular Advances for Extracranial Carotid Stenosis

Neurosurgery ◽  
2014 ◽  
Vol 74 (suppl_1) ◽  
pp. S92-S101 ◽  
Author(s):  
Jorge L. Eller ◽  
Travis M. Dumont ◽  
Grant C. Sorkin ◽  
Maxim Mokin ◽  
Elad I. Levy ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Endarterectomy ◽  
Carotid Stenosis ◽  
Carotid Artery Stenosis ◽  
Carotid Artery Stenting ◽  
Carotid Stenting ◽  
Historical Background ◽  
Treatment Modalities ◽  
Endovascular Management ◽  
The Past

Abstract Carotid artery stenting has become a viable alternative to carotid endarterectomy in the management of carotid stenosis. Over the past 20 years, many trials have attempted to compare both treatment modalities and establish the indications for each one, depending on clinical and anatomic features presented by patients. Concurrently, carotid stenting techniques and devices have evolved and made endovascular management of carotid stenosis safe and effective. Among the most important innovations are devices for distal and proximal embolic protection and new stent designs. This paper reviews these advances in the endovascular management of carotid artery stenosis within the context of the historical background.

scholarly journals Effect of Carotid Artery Stenting on Cognitive Function in Patients With Carotid Artery Stenosis: Preliminary Results

2008 ◽  
Vol 29 (2) ◽  
pp. 265-268 ◽  
Author(s):  
A.S. Turk ◽  
I. Chaudry ◽  
V.M. Haughton ◽  
B.P. Hermann ◽  
H.A. Rowley ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Carotid Artery ◽  
Carotid Artery Stenosis ◽  
Carotid Artery Stenting ◽  
Artery Stenosis ◽  
Preliminary Results

Transcarotid Artery Revascularization and Advances in Vascular Surgery for Carotid Artery Disease

2021 ◽  
Author(s):  
James Hu ◽  
◽  
Andy Sohn ◽  
Justin George ◽  
Rajesh Malik ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Vascular Surgery ◽  
Carotid Endarterectomy ◽  
Surgical Management ◽  
Carotid Artery Stenosis ◽  
Carotid Artery Stenting ◽  
Carotid Artery Disease ◽  
Artery Stenosis ◽  
Cerebrovascular Accidents ◽  
Artery Disease

Carotid artery atherosclerotic disease impacts over 2 million Americans annually. Since the advent of the carotid endarterectomy by Debakey in 1953, the surgical management of carotid artery stenosis has prevented cerebrovascular accidents. The technology utilized to manage carotid artery stenosis continued to evolve with the utilization of carotid artery stenting in 1989 and more recently transcarotid artery revascularization (TCAR). This review discusses the modern management of carotid artery stenosis with an emphasis on transcarotid artery revascularization (TCAR) and reversal of flow for reversal of flow for embolic protection.

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.

scholarly journals The Early Effect of Carotid Artery Stenting on Antioxidant Capacity and Oxidative Stress in Patients with Carotid Artery Stenosis

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Slawomir Michalak ◽  
Wojciech Ambrosius ◽  
Ewa Wysocka ◽  
Mieczyslaw Dziarmaga ◽  
Robert Juszkat ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Antioxidant Capacity ◽  
Carotid Artery Stenosis ◽  
Carotid Artery Stenting ◽  
Antioxidant Defense ◽  
Artery Stenosis ◽  
Sulfhydryl Groups ◽  
Early Effect ◽  
Spectrophotometric Methods ◽  
And Oxidative Stress

The treatment of carotid artery stenosis is associated with the risk of complications, which may include stroke after carotid artery stenting (CAS) and myocardial infarction after carotid endarterectomy (CEA). The imbalance between prooxidative mechanisms and antioxidant capacity creates a milieu of factors, which may increase the risk of complications after endovascular procedures. We have examined 43 consecutive patients with carotid artery stenosis. Sera were analyzed for the activity of paraoxonase (PON) and arylesterase (ARE), sulfhydryl groups (SG), malondialdehyde (MDA), and conjugated dienes (CD) concentrations by means of spectrophotometric methods before and next day after CAS. We have found lowered PON (P=0.0032), increase in ARE activity (P=0.0058), and decrease in sulfhydryl groups concentration (P=0.0267). No effect on absolute MDA and CD concentrations was observed. The degree of carotid artery stenosis correlated negatively with PON/ARE ratio after CAS (rS= −0.507,P=0.0268). To conclude, CAS influences both enzymatic (differently, PON and ARE activity) and nonenzymatic antioxidant defense. Females are more susceptible to lipid peroxidation after CAS. PON/ARE ratio after CAS correlated with the degree of carotid artery stenosis. The changes (deltas) in ARE activity, SG, and MDA concentrations correlated with the severity of neurological deficit and disability.

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