scholarly journals Carotid Artery Stenting for Carotid Arterial Fibromuscular Dysplasia Evaluated Vascular Wall Structure Using Optical Coherence Tomography: A Case Report

Author(s):  
Shogo Oshikata ◽  
Kei Harada ◽  
Masahito Kajihara ◽  
Kunihiro Ueta ◽  
Hideki Komatani
2017 ◽  
Vol 10 (3) ◽  
pp. 229-234 ◽  
Author(s):  
Kei Harada ◽  
Shogo Oshikata ◽  
Masahito Kajihara

Background and purposeDuring carotid artery stenting (CAS) with the use of closed cell design stents for unstable plaques, tissue prolapse between stent struts was evaluated by optical coherence tomography (OCT).Methods14 carotid stenosis lesions diagnosed as unstable plaques by MRI were evaluated by OCT imaging during CAS using closed cell stents. Cross sectional OCT images within the stented segment were evaluated at 1 mm intervals. The slice rate for the presence of tissue prolapse between the struts was calculated.ResultsNo intra-procedural complications occurred. After single stent placement, plaque prolapse was observed in all cases. Slices with any and >500 µm tissue prolapse were seen in 30% and 7.8% of cases, respectively. In 5 of 7 lesions with tissue prolapse >500 µm, additional stents were overlapped. In cases with overlapping stents, slices with any tissue prolapse were significantly decreased from 26% to 16% (p=0.008); in particular, the occurrence of tissue prolapse >500 µm was significantly decreased from 15% to 2.3% (p<0.001). In one case of >500 µm tissue prolapse without an overlapping stent, delayed embolization due to an in-stent thrombus occurred 9 months after the procedure.ConclusionsOCT during CAS using closed cell stent for unstable plaques frequently revealed tissue prolapse between struts. Placement of overlapping stents significantly reduced tissue prolapse, particularly tissue prolapse >500 µm. However, closed cell stents used for unstable plaques may not solve the problem of tissue prolapse.


2019 ◽  
Vol 9 (6) ◽  
pp. 484-486 ◽  
Author(s):  
Christopher R. Pasarikovski ◽  
Joel Ramjist ◽  
Leodante da Costa ◽  
Victor X.D. Yang

2019 ◽  
Vol 30 (3) ◽  
pp. 503-509 ◽  
Author(s):  
Christopher R. Pasarikovski ◽  
Joel Ramjist ◽  
Leodante da Costa ◽  
Sandra E. Black ◽  
Jillian Cardinell ◽  
...  

Neurology ◽  
2018 ◽  
Vol 90 (8) ◽  
pp. 384-385
Author(s):  
Naif M. Alotaibi ◽  
Francesca Sarzetto ◽  
Joel Ramjist ◽  
Victor X.D. Yang

2010 ◽  
Vol 67 (3) ◽  
pp. onsE305-onsE305 ◽  
Author(s):  
Shinichi Yoshimura ◽  
Masanori Kawasaki ◽  
Arihiro Hattori ◽  
Kazuhiko Nishigaki ◽  
Shinya Minatoguchi ◽  
...  

Abstract OBJECTIVE: Intraluminal thrombus in the carotid artery is often misdiagnosed because clinical imaging, such as angiography and duplex ultrasonography, fails to accurately identify it. Recently, it was reported that optical coherence tomography (OCT), a new imaging modality, can visualize intravascular thrombus in the coronary artery. CLINICAL PRESENTATION: An 83-year old male was admitted due to newly developed motor weakness of the left hand. Diffusion weighted magnetic resonance imaging showed multiple high intensity spots in the territory of the right middle cerebral artery, and magnetic resonance angiography revealed significant stenosis at the origin of the right internal carotid artery. Because of an apparent change in plaque shape on the angiogram just before carotid artery stenting, further examinations such as intravascular ultrasonography (IVUS) and OCT were performed. EXAMINATION: After IVUS examination, both the common carotid and external carotid arteries were occluded by an occlusion balloon system prepared for carotid artery stenting. Then the stenotic site was imaged by OCT from the distal section at 1mm/sec using a built-in pull-back system with continuous injection of saline through the guiding catheter to remove blood from the field of view. Since intraluminal thrombus was clearly demonstrated by an OCT, carotid endarterectomy was performed instead of stenting, and thrombus was confirmed by surgical specimen. CONCLUSION: OCT may provide useful information for diagnosis of an intraluminal thrombus in the carotid artery, which is important for the appropriate selection of therapeutic strategy.


2021 ◽  
Vol 20 (4) ◽  
pp. 2864
Author(s):  
D. G. Ioseliani ◽  
D. A. Asadov ◽  
V. V. Fomenko ◽  
A. V. Azarov ◽  
S. P. Semitko

The presented case report describes a five-year outcomes of bifurcation stenting of the left anterior descending artery and large diagonal branch with Absorb bioabsorbable vascular stent (BVS) according to selective coronary angiography and optical coherence tomography. The example demonstrates not only the successful implantation of biodegradable stents into the bifurcation area, but also the complete restoration of the arterial wall with the formation of neocarina. Optical coherence tomography made it possible to study in detail all stages of vascular wall alterations from the inside. This case report prompts a fresh look at the biodegradable BVS Absorb stents and does not rule out the potential of returning these stents to clinical practice in the future. Currently, the production and use of Absorb BVSs has been suspended, but they have filled a certain niche in the endovascular treatment of patients with coronary artery disease.


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