scholarly journals Clinical Comparison of Outcomes of Early versus Delayed Carotid Artery Stenting for Symptomatic Cerebral Watershed Infarction due to Stenosis of the Proximal Internal Carotid Artery

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Huakun Liu ◽  
Jianfeng Chu ◽  
Lei Zhang ◽  
Chaolai Liu ◽  
Zhongrui Yan ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Clinical Data ◽  
Symptom Onset ◽  
Carotid Artery Stenting ◽  
Internal Carotid ◽  
Internal Carotid Artery Stenosis ◽  
Proximal Internal Carotid Artery ◽  
Significant Difference ◽  
Watershed Infarction

The aim of this study was to compare the clinical outcomes of early versus delayed carotid artery stenting (CAS) for symptomatic cerebral watershed infarction (sCWI) patients due to stenosis of the proximal internal carotid artery. We retrospectively collected clinical data of those who underwent early or delayed CAS from March 2011 to April 2014. The time of early CAS and delayed CAS was within a week of symptom onset and after four weeks from symptom onset. Clinical data such as second stroke, the National Institutes of Health Stroke Scale (NHISS) score, and modified Rankin Scale (mRS) score and periprocedural complications were collected. The rate of second stroke in early CAS group is lower when compared to that of delayed CAS group. There was no significant difference regarding periprocedural complications in both groups. There was a significant difference regarding mean NHISS score 90 days after CAS in two groups. Early CAS group had a significant better good outcome (mRS score ≤ 2) than delayed CAS group. We suggest early CAS for sCWI due to severe proximal internal carotid artery stenosis as it provides lower rate of second stroke, comparable periprocedural complications, and better functional outcomes compared to that of delayed CAS.

scholarly journals Ocular and Cerebral Ischemic Mechanisms in Disease of the Internal Carotid Artery

1984 ◽  
Vol 11 (2) ◽  
pp. 262-268 ◽  
Author(s):  
R.T. Ross ◽  
Ian M. Morrow
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Ophthalmic Artery ◽  
Internal Carotid ◽  
Cell Aggregation ◽  
Internal Carotid Artery Stenosis ◽  
Circulation Time ◽  
Red Cell ◽  
Red Cell Deformability ◽  
Significant Difference

ABSTRACT:Stenosis of the internal carotid artery reduces the flow velocity in the ophthalmic artery. Lowered velocity permits increased red cell aggregation and decreased red cell deformability which increases viscosity.Contrary to the theory of remotely originating emboli, this is an alternate hypothesis regarding transient attacks of ocular and cerebral ischemia.The ophthalmic artery circulation time was measured in two groups of patients. The circulation time was defined as the interval between the appearance of contrast media in the siphon of the internal carotid artery and in the ocular choroid. The measurement was made on 151 angiograms of 108 subjects. These vessels were normal. An additional 76 patients had 108 angiograms which showed various amounts of internal carotid artery stenosis. These 76 patients had transient ischemic attacks; retinal, cerebral, or both.There is a significant difference in the ophthalmic artery circulation time in the two groups. The slowing in the ophthalmic artery is related to the degree of internal carotid artery narrowing.The circulation time in a cerebral branch of the internal carotid was not measured. It is presumed that stenosis of the internal carotid artery would have the same effect on a cerebral artery as on the ophthalmic artery.

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 Acute thromboses and occlusions of dual layer carotid stents in endovascular treatment of tandem occlusions

2019 ◽  
Vol 12 (1) ◽  
pp. 33-37 ◽  
Author(s):  
Johannes A R Pfaff ◽  
Christoph Maurer ◽  
Erasmia Broussalis ◽  
Hendrik Janssen ◽  
Raphael Blanc ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Neurological Outcome ◽  
Carotid Artery Stenting ◽  
Internal Carotid ◽  
Mechanical Thrombectomy ◽  
Thrombus Formation ◽  
Extracranial Internal Carotid Artery ◽  
Stent Occlusion ◽  
Significant Difference

PurposeTo evaluate the occurrence and risk factors of acute in-stent thrombosis or stent occlusion in patients with tandem occlusions receiving intracranial mechanical thrombectomy and emergent extracranial internal carotid artery stenting with a dual layer carotid stent.MethodsMulticenter retrospective data collection and analysis of stroke databases of seven comprehensive stroke centers from three European countries.ResultsOverall, 160 patients (mean (SD) age 66 (12) years; 104 men (65%); median (IQR) baseline NIHSS 14 (9–18); IV lysis, n=97 (60.6%)) were treated for a cervical carotid artery occlusion or stenosis using a CASPER stent (MicroVention), and received mechanical thrombectomy for an intracranial occlusion between April 2014 and November 2018. During the procedure or within 72 hours, formation of thrombus and complete occlusion of the CASPER stent was observed in 33/160 (20.8%) and in 12/160 patients (7.5%), respectively. In 25/33 (75.8%) and in 9/12 patients (75%), respectively, this occurred during the procedure. No statistically significant difference was observed between patients with and without thrombus formation with regard to pre-existing long term medication with anticoagulants or intraprocedural administration of heparin, acetylsalicylic acid (ASA), or heparin and ASA. Favorable early neurological outcome was similar in patients with (n=15; 45.5%) and without (n=63; 49.6%) thrombus formation at the CASPER stent.ConclusionAcute thrombosis or occlusion of CASPER stents in thrombectomy patients receiving emergent extracranial internal carotid artery stenting for tandem occlusions were observed more often during the procedure than within 72 hours of follow-up, were less frequent then previously reported, and showed no impact on early neurological outcome.

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