Cerebral Embolism during Carotid Artery Stenting: Role of Carotid Plaque Echolucency

2009 ◽  
Vol 27 (5) ◽  
pp. 443-449 ◽  
Author(s):  
Michael Rosenkranz ◽  
Oliver Wittkugel ◽  
Christian Waiblinger ◽  
Götz Thomalla ◽  
Anna Krützelmann ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Carotid Plaque ◽  
Cerebral Embolism

Near-infrared spectroscopy carotid plaque characteristics and cerebral embolism in carotid artery stenting

2021 ◽  
Vol 17 (7) ◽  
pp. 599-606
Author(s):  
Ichiro Nakagawa ◽  
Masashi Kotsugi ◽  
Hun Soo Park ◽  
Takanori Furuta ◽  
Fumiya Sato ◽  
...  
Keyword(s):  
Infrared Spectroscopy ◽  
Carotid Artery ◽  
Near Infrared Spectroscopy ◽  
Carotid Artery Stenting ◽  
Carotid Plaque ◽  
Near Infrared ◽  
Cerebral Embolism

Carotid Plaque Surface Irregularity Predicts Cerebral Embolism during Carotid Artery Stenting

2011 ◽  
Vol 32 (2) ◽  
pp. 164-170 ◽  
Author(s):  
Michael Rosenkranz ◽  
Arkadiusz Russjan ◽  
Einar Goebell ◽  
Stefanie Havemeister ◽  
Götz Thomalla ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Carotid Plaque ◽  
Cerebral Embolism ◽  
Surface Irregularity

The role of virtual reality in the training for carotid artery stenting: the perspective of trainees

2019 ◽  
Vol 26 (1) ◽  
Author(s):  
Daniela Mazzaccaro ◽  
Rim Miri ◽  
Bilel Derbel ◽  
Paolo Righini ◽  
Giovanni Nano
Keyword(s):  
Virtual Reality ◽  
Carotid Artery ◽  
Carotid Artery Stenting

Abstract WMP47: Cholesterol Crystals in Embolic Debris Correlate Postoperative Silent Cerebral Embolism in Carotid Artery Stenting

Stroke ◽  
2018 ◽  
Vol 49 (Suppl_1) ◽  
Author(s):  
Kota Maekawa ◽  
Masunari Shibata ◽  
Hidetaka Nakajima ◽  
Yotaro Kitano ◽  
Masaru Seguchi ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Cerebral Embolism ◽  
Cholesterol Crystals

Cholesterol Crystals in Embolic Debris are Associated with Postoperative Cerebral Embolism after Carotid Artery Stenting

2018 ◽  
Vol 46 (5-6) ◽  
pp. 242-248 ◽  
Author(s):  
Kota Maekawa ◽  
Masunari Shibata ◽  
Hideki Nakajima ◽  
Yotaro Kitano ◽  
Masaru Seguchi ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Blood Cells ◽  
Carotid Artery Stenting ◽  
Internal Carotid ◽  
White Blood Cells ◽  
Internal Carotid Artery Stenosis ◽  
Cerebral Embolism ◽  
Cholesterol Crystals ◽  
Ischemic Attack ◽  
Hematoxylin Eosin

Object: We investigated possible associations among the presence of cholesterol crystals in embolic debris, the proportions of debris components, and postoperative cerebral embolism in patients undergoing carotid artery stenting (CAS). Methods: Sixty-seven consecutive procedures were performed for internal carotid artery stenosis with CAS at our hospital between November 2015 and February 2018. Procedures for emergency CAS for stroke in evolution or crescendo transient ischemic attack were excluded (n = 12). The embolic debris from remaining procedures (n = 55) was stained with hematoxylin-eosin and the red blood cells, white blood cells, and fibrin were quantified by color-based segmentation. Cholesterol crystals and calcification were examined histopathologically. Diffusion-weighted imaging (DWI) was performed 1–3 days after CAS, and the images were used to classify procedures according to the presence of new lesions. Results: Of the 55 CAS procedures, new DWI lesions were identified after 32. One patient had symptomatic cerebral embolism. Higher proportions of patients with cholesterol crystals in embolic debris (17 vs. 78%, p < 0.001) and higher proportion of white blood cells (mean 2.3 [0–9.9] vs. 4.2% [0–29.9%], p < 0.01) were observed in the embolic debris of procedures with and without new DWI lesions. Conclusions: Cholesterol crystals were common in the embolic debris from patients with postoperative ischemic lesions after CAS. These results suggest that inflammatory destabilization of the intraplaque lipid component is related to postprocedural DWI lesions.

scholarly journals Carotid artery stenting: current role of proximal neuroprotection and technical advancements in stroke prevention

2015 ◽  
Vol 17 (suppl A) ◽  
pp. A29-A33 ◽  
Author(s):  
A. Cremonesi ◽  
M. Mussardo ◽  
P. Sbarzaglia ◽  
B. Spagnolo ◽  
C. Cavazza ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Stroke Prevention ◽  
Carotid Artery Stenting ◽  
Current Role

Management of Mobile Floating Carotid Plaque Using Carotid Artery Stenting

2003 ◽  
Vol 10 (3) ◽  
pp. 653-656 ◽  
Author(s):  
Elie Y. Chakhtoura ◽  
Jonathan E. Goldstein ◽  
Robert W. Hobson
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Carotid Plaque ◽  
Case Reports ◽  
Duplex Ultrasound ◽  
Carotid Stenting ◽  
Clinical Results ◽  
Unique Nature ◽  
Risk Patients ◽  
Ischemic Attack

Purpose: To present management techniques for dealing with mobile floating carotid plaque (MFCP), which represents an indeterminate risk of embolic cerebrovascular events. Case Reports: Two high-risk patients with a history of carotid endarterectomy were diagnosed with MFCP by duplex ultrasound scanning. One patient had a left hemispheric transient ischemic attack while the other was asymptomatic with a moderate stenosis. Both were successfully treated with carotid artery stenting, achieving complete coverage of the MFCP. Their outcomes were uneventful, and sustained patency of the stented arteries has been observed during an event-free survival of 32 and 44 months, respectively. Conclusions: Based upon the unique nature of these lesions and our satisfactory clinical results, we believe that carotid stenting may be a viable option for the treatment of MFCP.

What Have We Learned from the Imaging in Carotid Angioplasty and Risk of Stroke (ICAROS) Study?

Vascular ◽  
2004 ◽  
Vol 12 (1) ◽  
pp. 62-68 ◽  
Author(s):  
Giorgio M. Biasi ◽  
Alberto Froio ◽  
Gaetano Deleo ◽  
Claudia Piazzoni ◽  
Valter Camesasca
Keyword(s):  
Risk Factor ◽  
Clinical Practice ◽  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Carotid Plaque ◽  
Independent Risk Factor ◽  
Carotid Stenting ◽  
Computer Assisted ◽  
Carotid Angioplasty ◽  
Cerebral Embolization

Carotid artery stenting (CAS) is used widely to treat carotid lesions. Indication to CAS is mostly based, both in trial and in clinical practice, on the percentage of stenosis and the presence or absence of preprocedural neurologic symptoms, whereas the features of the plaque are somehow disregarded and ignored. The most severe complication of CAS is stroke, related to cerebral embolization from carotid plaque. Several studies showed that echolucent plaques generate a higher number of embolic particles following carotid stenting. Echolucency can be measured using the gray scale median, which is an objective and quantitative computer-assisted grading of the echogenicity of carotid plaques. As previously demonstrated in the ICAROS study, carotid plaque echolucency is an independent risk factor for stroke in carotid stenting. Carotid plaque echolucency is one of the parameters that should be mandatory to be considered for indication to treatment.

Relationship between carotid plaque characteristics and new ischemic lesions after stenting detected by computed tomography angiography

2019 ◽  
Vol 61 (1) ◽  
pp. 47-55
Author(s):  
Hongying Qu ◽  
Xiaokun Zhang ◽  
Miao Zhang ◽  
Yongan Gao ◽  
Jie Lu
Keyword(s):  
Risk Factors ◽  
Computed Tomography ◽  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Carotid Plaque ◽  
Diffusion Weighted Imaging ◽  
Irregular Surface ◽  
Irregular Surfaces ◽  
Diffusion Weighted ◽  
Peripheral Position

Background Although carotid artery stenting achieves definite benefits, it carries a higher rate of embolization compared with carotid endarterectomy. The incidence of embolization may be related to plaque stability. Purpose To assess for any relationship between plaque characteristics and cerebral emboli following carotid artery stenting. Material and Methods Sixty-three patients with severe carotid stenosis underwent carotid artery stenting. They were divided into two groups according to whether new ischemic lesions were detected on diffusion-weighted imaging after carotid artery stenting. We evaluated the types and locations of calcification in plaques and extent of calcification. We then assessed for a correlation between each of these factors and occurrence of new lesions on diffusion-weighted imaging after carotid artery stenting. Results The locations of calcification, percentage of plaque enhancement, and the number of plaques with irregular surface or ulceration were significantly different between the two groups. A peripheral position of calcification (close to the adventitia), enhancing plaques, and plaques with irregular surfaces or ulceration were statistically significant predictors of intracerebral embolization after carotid artery stenting. No significant differences in type of plaque or degree of calcification were found between two groups. Conclusion Peripheral calcification, enhancing plaques, and plaques with irregular surfaces were risk factors for intracerebral embolization after carotid artery stenting. These plaque characteristics should be considered when choosing the optimal treatment for patients.

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