Carotid Artery Stenting for the Treatment of Fatal Acute Cerebral Infarction Associated with Aortic Dissection

2020 ◽  
Vol 68 (1) ◽  
pp. 185
Author(s):  
Zhen-Hai Zhang ◽  
Yuan-Yuan Dang ◽  
Chun-Sen Shen
Keyword(s):  
Carotid Artery ◽  
Aortic Dissection ◽  
Cerebral Infarction ◽  
Carotid Artery Stenting ◽  
Acute Cerebral Infarction

Successful carotid artery stenting in patients with aortic dissection

2020 ◽  
Keyword(s):  
Ischemic Stroke ◽  
Carotid Artery ◽  
Aortic Dissection ◽  
Cerebral Infarction ◽  
Acute Ischemic Stroke ◽  
Aortic Arch ◽  
Common Carotid Artery ◽  
Carotid Artery Stenting ◽  
Acute Aortic Dissection ◽  
Optimal Timing

Background: There are no guidelines for the optimal timing of surgery (emergency vs. delayed) for ascending aortic dissection with acute ischemic stroke. We retrospectively compared the prognoses and radiological and clinical findings for concomitant aortic dissection and ischemic stroke in a series of case reports. Case presentation: Three patients presented with left hemiparesis. Patient 1 underwent surgery for acute aortic dissection without treatment for acute ischemic stroke. In Patient 2, emergency stenting could not be performed due to cardiac tamponade and hypotension. Therefore, emergency acute aortic dissection surgery was performed. Patient 3 underwent emergency right common carotid artery stenting followed by surgery for acute aortic dissection. Brain perfusion computed tomography angiography (CTA) was performed to diagnose severe stenosis of the right common carotid artery or occlusion concomitant with acute aortic dissection involving the aortic arch with a cerebral perfusion mismatch in all the patients. Patient 3 had postoperative local cerebral infarction, whereas patients 1 and 2 (without stent insertion) had extensive postoperative cerebral infarction. Conclusion: Patient 3 showed a better prognosis than patients without stent treatment. We suggest that perfusion CTA of the aortic arch in suspected acute ischemic stroke can facilitate early diagnosis and prompt treatment in similar patients.

scholarly journals Mechanical thrombectomy and carotid artery stenting for stenosis of the internal carotid artery with free-floating thrombosis: illustrative case

2021 ◽  
Vol 2 (9) ◽  
Author(s):  
Ryuta Tomoyose ◽  
Tomoyuki Tsumoto ◽  
Kenta Hara ◽  
Yuichi Miyazaki ◽  
So Tokunaga ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Cerebral Infarction ◽  
Carotid Artery Stenting ◽  
Internal Carotid ◽  
Mechanical Thrombectomy ◽  
Acute Cerebral Infarction ◽  
Reversal Flow ◽  
Ica Stenosis

BACKGROUND The authors report a case in which mechanical thrombectomy and carotid artery stenting (CAS) were performed for acute cerebral infarction with free-floating thrombosis (FFT) in left internal carotid artery (ICA) stenosis. Good results were obtained. OBSERVATIONS A 63-year-old man developed sudden disturbance of consciousness and right hemiplegia. He was transported to the authors’ hospital by an emergency vehicle. Head magnetic resonance imaging showed acute cerebral infarction in the left middle cerebral artery region, and magnetic resonance angiography showed poor vascular flow beyond the left ICA. Emergency angiography revealed severe stenosis at the origin of the left ICA and a free-floating thrombus attached to the stenosis and extending to the peripheral side. Percutaneous transluminal angioplasty (PTA) was performed on the stenosis with proximal protection, the thrombus was aspirated under reversal flow, and CAS was performed without exacerbation of clinical symptoms. LESSONS PTA, thrombus aspiration, and CAS under reversal flow may be effective treatments for FFT caused by ICA stenosis.

scholarly journals Correlation Between Serum C-Reactive Protein And Cystatin C In Patients With Acute Cerebral Infarction And Carotid Artery Stenosis

2018 ◽  
Vol 7 (1) ◽  
Author(s):  
Tao Zhang ◽  
Xiaowen Yang ◽  
Hui Wang ◽  
Jie Luo ◽  
Anrong Li ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Cerebral Infarction ◽  
Carotid Artery Stenosis ◽  
Serum Levels ◽  
Artery Stenosis ◽  
Acute Cerebral Infarction ◽  
Control Group ◽  
Case Group ◽  
Reactive Protein ◽  
Serum Crp

<p><em>To investigate the correlation between serum C-reactive protein (CRP) and serum cystatin C (Cys-C) levels in patients with acute cerebral infarction and carotid artery stenosis. Methods: From January 2015 to December 2016 admitted to our hospital new acute cerebral infarction parallel neck vascular color Doppler ultrasound examination showed 121 cases of carotid stenosis as the case group; select the same period of hospitalized patients with non-cerebrovascular disease in 50 cases As a control group. Fasting venous blood was collected on the third day after onset of the disease and serum levels of CRP and Cys-C were measured and compared. Results: Serum levels of CRP and Cys-C in case group were significantly higher than those in control group (P &lt;0.05). The correlation between serum CRP and Cys-C was found in any pairwise comparison (r = 0.4732). The level of CRP and Cys-C were closely related to the degree of carotid artery stenosis (P &lt;0.05). Conclusion: The combined detection of serum CRP and Cys-C levels can be used to evaluate the degree of carotid artery stenosis in patients with acute cerebral infarction and provide a reference for the next carotid endarterectomy.</em><em></em></p>

Familial Hypercholesterolemia and Cerebral Infarction - A Case Report

2021 ◽  
Author(s):  
Huajun Jiang ◽  
Qu Wei ◽  
Liang Zhanhua ◽  
Yang Jingjing
Keyword(s):  
Family History ◽  
Carotid Artery ◽  
Cerebral Infarction ◽  
Carotid Stenosis ◽  
Familial Hypercholesterolemia ◽  
Acute Cerebral Infarction ◽  
Ldlr Gene ◽  
History Of ◽  
The Right ◽  
Arterial Plaques

Abstract Background: Familial hypercholesterolemia has various presentations mostly including early-onset cardiovascular diseases, remarkable skin and tendon xanthomas. By comparison, Cerebral Infarction due to familial hypercholesterolemia is extremely rare. Case presentation: We present a 41-year-old man who was admitted to our hospital with dizziness, vertigo, slurred speech, weakness in his left limbs. He had family history of Hyperlipidemia in older sister . Head CT scan demonstrated multiple acute cerebral infarction in the right frontal and parietal lobes, and arterial plaques was found in the bifurcation of common carotid artery. The severe carotid stenosis was located in the initial segment of the right internal carotid artery. Histopathologic findings were consistent with xanthoma. Especially, molecular analysis of the LDLR gene was made, which identified heterozygous missense mutation in exon 12 of the LDLR gene. The final diagnosis of cerebral infarction associated with familial hypercholesterolemia was made. The patient was referred to a nutritionist for dietary advice, and was treated with Tab. Finally, the patient recovered well. The symptoms of brain infarct vanished and no recurrence occurred during follow-up.Conclusions: In the present case, the acute cerebral infarction is most likely due to hypercholesterolemia, as his family history of hypercholesterolemia, and arterial plaques and severe carotid stenosis was found by CTA. This case highlights the importance of the early diagnosis and treatment of hypercholesterolemia, which may help in preventing the development of cardiovascular and cerebrovascular diseases.

scholarly journals Assessing short-term outcomes of carotid artery stenting at Hue Central Hospital

2020 ◽  
Author(s):  
Hai Phu Hoang
Keyword(s):  
Carotid Artery ◽  
Cerebral Infarction ◽  
Cerebral Hemorrhage ◽  
Carotid Artery Stenting ◽  
Carotid Stenting ◽  
Medical Problem ◽  
Internal Carotid Artery Stenosis ◽  
Central Hospital ◽  
Short Term ◽  
Bilateral Carotid

ASSESSING SHORT-TERM OUTCOMES OF CAROTID ARTERY STENTING AT HUE CENTRAL HOSPITAL ABSTRACT Stroke is an important medical problem in all countries of the world. Preventing stroke is a priority goal of community health programs and each individual. Carotid stenting is a less invasive alternative in comparison to surgery. This study was conducted on 19 patients with internal carotid artery stenosis, in which the stent was placed to recreate the flow, at Hue Central Hospital from January 2018 to January 2020. Results: Age was 61.1 ± 16.1 years, history stroke was 57.9%, hypertension was 78.8%, dyslipidemia was 68.4%, smoking was 57.9%, bilateral carotid lesion was 57.9%, the patients whose stenosis was ≥70% and ≥ 90% accounted for 100% and 47.4% respectively, the success of the procedure was 100%, blood flow to the brain improved (36.7%). There was no case with dangerous events such as embolism, infarction or cerebral hemorrhage. After 6 months, clinical outcomes and the prognosis improved according to NIHSS and mRS. No death or complication of cerebral infarction, cerebral hemorrhage was reported. Key words: carotid artery, stent, cerebral infarction, cerebral hemorrhage

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