scholarly journals A Case of Acute Ischemic Stroke Treated with Endovascular Treatment for Tandem Occlusion of the Common Carotid Artery and Internal Carotid Artery Terminal Portion Related to Takayasu Arteritis

2020 ◽  
Author(s):  
Kentaro Tatsuno ◽  
Toshihiro Ueda ◽  
Noriko Usuki ◽  
Haruki Otsubo ◽  
Takashi Araga ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Endovascular Treatment ◽  
Takayasu Arteritis ◽  
Common Carotid Artery ◽  
Internal Carotid ◽  
Terminal Portion ◽  
Tandem Occlusion ◽  
The Common

scholarly journals Direct Percutaneous Carotid Artery Stenting for a Patient with Absence of the Common Carotid Artery

2012 ◽  
Vol 18 (3) ◽  
pp. 320-325 ◽  
Author(s):  
S. Toyota ◽  
A. Wakayama ◽  
T. Yoshimine
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Common Carotid Artery ◽  
Carotid Artery Stenosis ◽  
Carotid Artery Stenting ◽  
Internal Carotid ◽  
Postoperative Radiotherapy ◽  
Internal Carotid Artery Stenosis ◽  
Tonsillar Carcinoma ◽  
The Common

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.

scholarly journals Thrombus Imaging Characteristics and Outcomes in Acute Ischemic Stroke Patients Undergoing Endovascular Treatment

Stroke ◽  
2019 ◽  
Vol 50 (8) ◽  
pp. 2057-2064 ◽  
Author(s):  
Bruna G. Dutra ◽  
Manon L. Tolhuisen ◽  
Heitor C.B.R. Alves ◽  
Kilian M. Treurniet ◽  
Manon Kappelhof ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Endovascular Treatment ◽  
Acute Ischemic Stroke ◽  
Functional Outcome ◽  
Odds Ratio ◽  
Internal Carotid ◽  
Common Odds Ratio ◽  
Imaging Characteristics

Background and Purpose— Thrombus imaging characteristics have been reported to be useful to predict functional outcome and reperfusion in acute ischemic stroke. However, conflicting data about this subject exist in patients undergoing endovascular treatment. Therefore, we aimed to evaluate whether thrombus imaging characteristics assessed on computed tomography are associated with outcomes in patients with acute ischemic stroke treated by endovascular treatment. Methods— The MR CLEAN (Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands) Registry is an ongoing, prospective, and observational study in all centers performing endovascular treatment in the Netherlands. We evaluated associations of thrombus imaging characteristics with the functional outcome (modified Rankin Scale at 90 days), mortality, reperfusion, duration of endovascular treatment, and symptomatic intracranial hemorrhage using univariable and multivariable regression models. Thrombus characteristics included location, clot burden score (CBS), length, relative and absolute attenuation, perviousness, and distance from the internal carotid artery terminus to the thrombus. All characteristics were assessed on thin-slice (≤2.5 mm) noncontrast computed tomography and computed tomography angiography, acquired within 30 minutes from each other. Results— In total, 408 patients were analyzed. Thrombus with distal location, higher CBS, and shorter length were associated with better functional outcome (adjusted common odds ratio, 3.3; 95% CI, 2.0–5.3 for distal M1 occlusion compared with internal carotid artery occlusion; adjusted common odds ratio, 1.15; 95% CI, 1.07–1.24 per CBS point; and adjusted common odds ratio, 0.96; 95% CI, 0.94–0.99 per mm, respectively) and reduced duration of endovascular procedure (adjusted coefficient B, −14.7; 95% CI, −24.2 to −5.1 for distal M1 occlusion compared with internal carotid artery occlusion; adjusted coefficient B, −8.5; 95% CI, −14.5 to −2.4 per CBS point; and adjusted coefficient B, 7.3; 95% CI, 2.9–11.8 per mm, respectively). Thrombus perviousness was associated with better functional outcome (adjusted common odds ratio, 1.01; 95% CI, 1.00–1.02 per Hounsfield units increase). Distal thrombi were associated with successful reperfusion (adjusted odds ratio, 2.6; 95% CI, 1.4–4.9 for proximal M1 occlusion compared with internal carotid artery occlusion). Conclusions— Distal location, higher CBS, and shorter length are associated with better functional outcome and faster endovascular procedure. Distal thrombus is strongly associated with successful reperfusion, and a pervious thrombus is associated with better functional outcome.

High Spatial Inhomogeneity in the Intima-Media Thickness of the Common Carotid Artery is Associated with a Larger Degree of Stenosis in the Internal Carotid Artery: The PARISK Study

2016 ◽  
Vol 38 (05) ◽  
pp. 523-529 ◽  
Author(s):  
Jeire Steinbuch ◽  
Anouk van Dijk ◽  
Floris Schreuder ◽  
Martine Truijman ◽  
Alexandra de Rotte ◽  
...  
Keyword(s):  
Risk Factors ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Common Carotid Artery ◽  
Internal Carotid ◽  
Intima Media Thickness ◽  
Media Thickness ◽  
Common Risk Factors ◽  
The Common ◽  
Ica Stenosis

Abstract Purpose Inhomogeneity of arterial wall thickness may be indicative of distal plaques. This study investigates the intra-subject association between relative spatial intima-media thickness (IMT) inhomogeneity of the common carotid artery (CCA) and the degree of stenosis of plaques in the internal carotid artery (ICA). Materials and Methods We included 240 patients with a recent ischemic stroke or transient ischemic attack and mild-to-moderate stenosis in the ipsilateral ICA. IMT inhomogeneity was extracted from B-mode ultrasound recordings. The degree of ICA stenosis was assessed on CT angiography according to the European Carotid Surgery Trial method. Patients were divided into groups with a low (≤ 2 %) and a high (> 2 %) IMT inhomogeneity scaled with respect to the local end-diastolic diameter. Results 182 patients had suitable CT and ultrasound measurements. Relative CCA-IMT inhomogeneity was similar for the symptomatic and asymptomatic side (difference: 0.02 %, p = 0.85). High relative IMT inhomogeneity was associated with a larger IMT (difference: 235 µm, p < 0.001) and larger degree of ICA stenosis (difference: 5 %, p = 0.023) which remained significant (p = 0.016) after adjustment for common risk factors. Conclusion Regardless of common risk factors, high relative CCA-IMT inhomogeneity is associated with a greater degree of ICA stenosis and is therefore indicative of atherosclerotic disease. The predictive value of CCA-IMT inhomogeneity for plaque progression and recurrence of cerebrovascular symptoms will be determined in the follow-up phase of PARISK.

scholarly journals Management of acute ischemic stroke due to tandem occlusion: should endovascular recanalization of the extracranial or intracranial occlusive lesion be done first?

2017 ◽  
Vol 42 (4) ◽  
pp. E16 ◽  
Author(s):  
Leonardo Rangel-Castilla ◽  
Gary B. Rajah ◽  
Hakeem J. Shakir ◽  
Hussain Shallwani ◽  
Sirin Gandhi ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Clinical Outcome ◽  
Internal Carotid Artery ◽  
Endovascular Treatment ◽  
Carotid Artery Stenting ◽  
Internal Carotid ◽  
National Institutes Of Health ◽  
Present Treatment ◽  
Tandem Occlusion ◽  
Cervical Internal Carotid Artery

OBJECTIVE Acute tandem occlusions of the cervical internal carotid artery and an intracranial large vessel present treatment challenges. Controversy exists regarding which lesion should be addressed first. The authors sought to evaluate the endovascular approach for revascularization of these lesions at Gates Vascular Institute. METHODS The authors performed a retrospective review of a prospectively maintained, single-institution database. They analyzed demographic, procedural, radiological, and clinical outcome data for patients who underwent endovascular treatment for tandem occlusions. A modified Rankin Scale (mRS) score ≤ 2 was defined as a favorable clinical outcome. RESULTS Forty-five patients were identified for inclusion in the study. The average age of these patients was 64 years; the mean National Institutes of Health Stroke Scale score at presentation was 14.4. Fifteen patients received intravenous thrombolysis before undergoing endovascular treatment. Thirty-seven (82%) of the 45 proximal cervical internal carotid artery occlusions were atherothrombotic in nature. Thirty-eight patients underwent a proximal-to-distal approach with carotid artery stenting first, followed by intracranial thrombectomy, whereas 7 patients underwent a distal-to-proximal approach (that is, intracranial thrombectomy was performed first). Thirty-seven (82%) procedures were completed with local anesthesia. For intracranial thrombectomy procedures, aspiration alone was used in 15 cases, stent retrieval alone was used in 5, and a combination of aspiration and stent-retriever thrombectomy was used in the remaining 25. The average time to revascularization was 81 minutes. Successful recanalization (thrombolysis in cerebral infarction Grade 2b/3) was achieved in 39 (87%) patients. Mean National Institutes of Health Stroke Scale scores were 9.3 immediately postprocedure (p < 0.05) (n = 31), 5.1 at discharge (p < 0.05) (n = 31), and 3.6 at 3 months (p < 0.05) (n = 30). There were 5 in-hospital deaths (11%); and 2 patients (4.4%) had symptomatic intracranial hemorrhage within 24 hours postprocedure. Favorable outcomes (mRS score ≤ 2) were achieved at 3 months in 22 (73.3%) of 30 patients available for follow-up, with an mRS score of 3 for 7 of 30 (23%) patients. CONCLUSIONS Tandem occlusions present treatment challenges, but high recanalization rates were possible in the present series using acute carotid artery stenting and mechanical thrombectomy concurrently. Proximal-to-distal and aspiration approaches were most commonly used because they were safe, efficacious, and feasible. Further study in the setting of a randomized controlled trial is needed to determine the best sequence for the treatment approach and the best technology for tandem occlusion.

scholarly journals Carotid artery diameter assessment in men and women and the relation to age, sex and body mass index using ultrasonography

2021 ◽  
Vol 8 (9) ◽  
pp. 1274
Author(s):  
Magaji G. Ojaare ◽  
Terkimbi I. Annongu ◽  
Chia D. Msuega ◽  
Hameed O. Mohammad ◽  
Abubakar Farati ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Body Mass ◽  
Common Carotid Artery ◽  
Carotid Arteries ◽  
Internal Carotid ◽  
Left Internal Carotid Artery ◽  
Luminal Diameter ◽  
The Common

Background: Carotid artery dimensions are increasingly used for detecting early atherosclerosis and predicting clinical complications. Aim was to explore relationships between gender, age and body mass index (BMI) and the diameters of the common carotid artery (CCA) and internal carotid artery (ICA) using ultrasonography.Methods: This was a cross-sectional study carried out at the University of Maiduguri Teaching Hospital between February-October, 2011. The 400 adult males and females above 18 years underwent carotid artery ultrasonography for measurement of the IMT of the common and internal carotid arteries. The influence of age, sex, weight, height, and the basal metabolic index (BMI) was investigated.Results: There were 239 (59.80%) males and 161 (40.20%) females aged between 18 to 81 years (Mean±SD, 36.74±14.79 years). The mean±SD diameters for right common carotid artery (RCCA) and left common carotid artery (LCCA) were 6.39±0.71mm and 6.28±0.74mm respectively. The right internal carotid artery (RICA) and left internal carotid artery (LICA) had mean±SD diameters of 4.63±0.63 mm and 4.61±0.63 mm respectively. The luminal diameters of the carotid arteries increased significantly with age and increased BMI. The luminal diameters of the CCA and ICA were significantly smaller in women than in men.Conclusions: Common carotid and internal carotid artery luminal diameter tends to be larger in men than women among adults and increases with age and BMI. There is no difference in the luminal diameter between the left and right carotid artery. 

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