scholarly journals Carotid endarterectomy as the treatment of choice for clearing the internal carotid artery in transitional ischemic attacks

2021 ◽  
Author(s):  
Tibério Alves da Silva ◽  
Ana Carolina Soares de Lira ◽  
Bárbara Letícia Barreto Ramos Aragão ◽  
Luciana Karla, Dayanna Grazielle Maia Viana

Introduction: TIAs are ischemia, caused by stenosis of the carotid and vertebral arteries. Those who have a TIA are at risk of ischemic stroke and myocardial infarction, with carotid endarterectomy being an intervention. Objective: To analyze the benefits of carotid endarterectomy using drugs. Methods: Literature review, in bases such as PUBMED, MEDLINE, descriptors: “Endarterectomy”, “Ischemic Attack”, with operator “AND” and “OR”. Those with two descriptors were selected in the summary and date between 2010-2020, English / Portuguese language, resulting in: 17 articles. Results: The internal carotid artery (ICA) is located in the neck as a branch of the common carotid artery, being one of its branches the middle cerebral artery (MCA), the main artery affected in strokes and TIAs. Thus, ACI ischemia causes a risk of thrombosis in MCA, the treatment of carotid stenosis requires drugs to prevent atheroma, as well as antiplatelet drugs to reduce embolic events¹. In some cases, carotid endarterectomy or carotid stent implantation is complementary. Therefore, patients with TIA or stroke, who have “transient, fluctuating or persistent unilateral motor weakness or speech disorder or eye symptoms”, should undergo endarterectomy if they have moderate-severe stenosis of the extracranial internal carotid artery in the first days of presentation². Thus, endarterectomy is the treatment of choice and stenting should only be offered to symptomatic patients. Conclusion: Therefore, endarterectomy has been shown to be safe for patients with internal carotid artery stenosis, indicating the prevalence in relation to the stent.

2012 ◽  
Vol 18 (3) ◽  
pp. 320-325 ◽  
Author(s):  
S. Toyota ◽  
A. Wakayama ◽  
T. Yoshimine

A 54-year-old man with symptomatic internal carotid artery stenosis with absence of the common carotid artery (CCA), who had been treated with surgery and postoperative radiotherapy for tonsillar carcinoma, underwent direct percutaneous carotid artery stenting (CAS). To our knowledge, this is the first report of direct percutaneous carotid artery stenting (CAS) for a patient with absent CCA.


2003 ◽  
Vol 9 (1_suppl) ◽  
pp. 143-148 ◽  
Author(s):  
H. Fukuda ◽  
K. Iihara ◽  
N. Sakai ◽  
K. Murao ◽  
H. Sakai ◽  
...  

The purpose of this study was to evaluate the efficacy and safety of staged carotid stenting (CS) and carotid endarterectomy (CEA) for bilateral internal carotid artery stenosis. With this strategy, initial carotid stenting was performed for the high grade carotid stenosis to reduce the risk of subsequent CEA. Eight patients were treated with staged CS and CEA; CS for asymptomatic side followed by CEA for symptomatic side. Sufficient revascularization was obtained in all procedures but one CS procedure. Two minor stroke caused by distal embolism occurred during the perioperative period of CS. Postprocedural persistent hypotension was observed in one CS procedure. The mean interval between CS and CEA was 19.8 days. In conclusion, although our strategy has some advantages such as avoidance of bilateral cranial nerve palsy and shorter admission period over staged CEA, relatively high complication rate was noted at the first CS without any stroke morbidity post CEA. Our preliminary result showed that further reduction of periprocedural complication rate at the initial stenting is mandatory for this approach justified.


Stroke ◽  
2014 ◽  
Vol 45 (10) ◽  
pp. 2995-3001 ◽  
Author(s):  
Angelia C. Kirkpatrick ◽  
Alfonso J. Tafur ◽  
Andrea S. Vincent ◽  
George L. Dale ◽  
Calin I. Prodan

Neurosurgery ◽  
2001 ◽  
Vol 48 (2) ◽  
pp. 328-333 ◽  
Author(s):  
Shoichiro Kawaguchi ◽  
Shuzo Okuno ◽  
Toshisuke Sakaki ◽  
Norikiyo Nishikawa

Abstract OBJECTIVE We evaluated the effect of carotid endarterectomy on chronic ocular ischemic syndrome due to internal carotid artery stenosis by use of data obtained from ophthalmic artery color Doppler flow imaging. METHODS We examined 11 patients with ocular ischemic syndrome due to internal carotid artery stenosis (>70% stenosis) who were being treated by carotid endarterectomy. Ophthalmic artery color Doppler flow imaging indicated ophthalmic artery flow direction and peak systolic flow velocity and was performed before and at 1 week, 1 month, and 3 months after surgery. RESULTS We assessed the ophthalmic arteries of 11 patients via color Doppler flow imaging. Before undergoing carotid endarterectomy, five patients showed reversed ophthalmic artery flow. In the other six patients who experienced antegrade ophthalmic artery flow, the average peak systolic flow velocity was 0.09 ± 0.05 m/s (mean ± standard deviation). Preoperative reversed flow resolved in each patient 1 week after undergoing surgery. All patients showed antegrade ophthalmic artery flow. The average peak systolic flow velocity in the patients who had preoperative antegrade flow rose significantly, to 0.21 ± 0.14 m/s (P < 0.05). There was no significant change as compared with findings at 1 week after surgery. During the follow-up period (mean, 32.4 mo), no patients complained of recurrent visual symptoms. At the end of the study period, visual acuity had improved in five patients and had not worsened in the other six patients. CONCLUSION Carotid endarterectomy was effective for improving or preventing the progress of chronic ocular ischemia caused by internal carotid artery stenosis.


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