scholarly journals Safety and Efficacy of Flow Reversal in Acute and Elective Carotid Angioplasty and Stenting Using the Mo.Ma Device with Short-Term Follow-Up

2019 ◽  
Vol 8 (2-6) ◽  
pp. 196-205
Author(s):  
Ambooj Tiwari ◽  
Ryan Bo ◽  
Keithan Sivakumar ◽  
Karthikeyan M. Arcot ◽  
Philip Ye ◽  
...  
Keyword(s):  
Flow Reversal ◽  
Carotid Angioplasty ◽  
Short Term ◽  
Safety And Efficacy ◽  
Carotid Revascularization ◽  
Subacute Stroke ◽  
Angioplasty And Stenting ◽  
Carotid Angioplasty And Stenting ◽  
Radiographic Data

Objective: To determine the safety and efficacy of flow reversal following proximal flow arrest as an embolic protection strategy for carotid angioplasty and stenting (CAS) with short-term follow-up. Method: We performed a retrospective review of our CAS database for patients who underwent stent-supported carotid revascularization in the setting of acute/subacute stroke or TIA. We reviewed clinical and radiographic data during a 36-month period. Primary outcome was clinical evidence of ipsilateral stroke in the first 30 days. Secondary outcomes include clinical outcomes and sonographic and/or angiographic follow-up over 6 months, 6-month functional scale, and all-cause mortality. Results: Fifty-five patients underwent CAS using flow reversal: 26 females and 29 males with a mean age of 69.7 years. Median time to treatment from index event was 3 days. 11% underwent stenting as part of hyperacute stroke therapy. Average luminal stenosis was 86%. The 9-Fr Mo.Ma device was used in combination with Penumbra aspiration in all cases. There were no ipsilateral strokes. Incidence of any ischemic event was 3.64%, but only 1 (1.82%) patient had a postoperative stroke. Clinical follow-up was available for 94.5%, while lesion follow-up was available for 73% of patients. Three patients had evidence of restenosis, but none were symptomatic. Luminal restenosis was ≤30% in all three. Median pre- and post-NIHSS were 1 and 1, respectively. Conclusion: Flow reversal using the Mo.Ma device is a safe and effective strategy in preventing distal embolization during carotid artery revascularization.

Safety and Efficacy of Carotid Angioplasty and Stenting in High-Risk Patients

2006 ◽  
Vol 72 (8) ◽  
pp. 694-699 ◽  
Author(s):  
Rabih A. Chaer ◽  
Brian G. Derubertis ◽  
Susan M. Trocciola ◽  
Stephanie C. Lin ◽  
Robert Hynecek ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
High Risk ◽  
Confidence Interval ◽  
Carotid Angioplasty ◽  
Safety And Efficacy ◽  
High Risk Patients ◽  
Risk Patients ◽  
Angioplasty And Stenting ◽  
Carotid Angioplasty And Stenting

Performance of carotid endarterectomy (CEA) may be associated with an increased risk in patients with significant comorbid medical conditions, neck irradiation, or previous CEA. This study compared the results of CEA with carotid angioplasty and stenting (CAS) in high-risk patients treated for carotid stenosis. Five hundred forty-five patients who underwent CEA and 148 patients who underwent CAS were evaluated. For patients undergoing CEA, general anesthesia was used in 91 per cent, electroencephalographic monitoring was used in 63 per cent, and shunting was performed in 19.8 per cent. Cerebral protection devices were used in 145/148 of CAS cases, and self-expanding stents were used in all cases. Evaluated end points included major cardiovascular events, and a composite of death, stroke, or myocardial infarction for the duration of the follow-up. Mean follow-up was 18 months for CAS and 23 months for CEA. Significant differences were present in patient age (CAS, 75 ± 11.0 years vs CEA, 71 ± 9 years, P = 0.012), however, there were no significant differences ( P = NS) in gender or smoking history. The mean modified Goldman Score was significantly higher for CAS (21.1 ± 14.8 [95% confidence interval = 18, 24]) than for CEA (6.3 ± 6.8 [95% confidence interval = 5.7, 6.9]; P = 0.0001) patients. The incidence of periprocedural complications did not vary significantly between patients treated with CAS (CVA, 1.4%; myocardial infarction [MI], 1.4%; death, 0.7%; CVA/MI/death, 3.4%) compared with CEA (CVA, 1.8%; MI, 1.1%; death, 0.4%; CVA/MI/death, 4.0%). CAS is equivalent to CEA in safety and efficacy, even when performed in patients who may be at increased surgical risk.

scholarly journals SS31. Diabetes is Not a Predictor of Adverse Outcome after Carotid Revascularization with Carotid Angioplasty and Stenting (CAS)

2011 ◽  
Vol 53 (6) ◽  
pp. 102S-103S
Author(s):  
Paola De Rango ◽  
Enrico Cieri ◽  
Gianbattista Parlani ◽  
Fabio Verzini ◽  
Gioele Simonte ◽  
...  
Keyword(s):  
Adverse Outcome ◽  
Carotid Angioplasty ◽  
Carotid Revascularization ◽  
Angioplasty And Stenting ◽  
Carotid Angioplasty And Stenting

The role of carotid angioplasty and stenting in carotid revascularization

2005 ◽  
Vol 27 (sup1) ◽  
pp. 53-58 ◽  
Author(s):  
Christopher J. Koebbe ◽  
Kenneth Liebman ◽  
Erol Veznedaroglu ◽  
Robert Rosenwasser
Keyword(s):  
Carotid Angioplasty ◽  
Carotid Revascularization ◽  
Angioplasty And Stenting ◽  
Carotid Angioplasty And Stenting

scholarly journals Restenosis after carotid angioplasty and stenting: A follow-up study with duplex ultrasonography

2003 ◽  
Vol 26 (2) ◽  
pp. 141-144 ◽  
Author(s):  
M.H. Christiaans ◽  
J.M.P.G. Ernst ◽  
M.J. Suttorp ◽  
J.C. van den Berg ◽  
T.Th.C. Overtoom ◽  
...  
Keyword(s):  
Duplex Ultrasonography ◽  
Carotid Angioplasty ◽  
Follow Up Study ◽  
Angioplasty And Stenting ◽  
Carotid Angioplasty And Stenting

Retinal Embolization During Carotid Angioplasty and Stenting: Periprocedural Data and Follow-Up

2009 ◽  
Vol 33 (4) ◽  
pp. 714-719 ◽  
Author(s):  
J. A. Vos ◽  
M. H. van Werkum ◽  
J. H. G. M. Bistervels ◽  
R. G. A. Ackerstaff ◽  
S. C. Tromp ◽  
...  
Keyword(s):  
Carotid Angioplasty ◽  
Angioplasty And Stenting ◽  
Carotid Angioplasty And Stenting

scholarly journals Transcarotid artery revascularization (TCAR): a technical video

2021 ◽  
pp. neurintsurg-2021-018024
Author(s):  
Nanthiya Sujijantarat ◽  
Joseph Antonios ◽  
Andrew Koo ◽  
Daniela Renedo ◽  
Branden J Cord ◽  
...  
Keyword(s):  
Routine Clinical Practice ◽  
Carotid Angioplasty ◽  
Operative Techniques ◽  
Content Type ◽  
Carotid Revascularization ◽  
Endovascular Approach ◽  
Angioplasty And Stenting ◽  
Video Player ◽  
Carotid Angioplasty And Stenting ◽  
Stenting Procedure

Carotid revascularization is an important method of stroke prevention and includes carotid endarterectomy and transfemoral carotid angioplasty and stenting. More recently, a hybrid open-endovascular approach, termed transcarotid artery revascularization (TCAR), is garnering increased attention. Although fundamentally a ‘stenting procedure’, unlike transfemoral carotid angioplasty and stenting, TCAR allows for a proximal neuroprotection strategy based on flow reversal. In this technical video, we will review operative techniques and nuances of the TCAR procedure, with a particular focus on the neurovascular proceduralist looking to adopt this technique into routine clinical practice(video 1).Video 1

scholarly journals Outcomes after Carotid Angioplasty and Stenting in Symptomatic Octogenarians

2011 ◽  
Vol 38 (3) ◽  
pp. 446-451 ◽  
Author(s):  
M. A. Almekhlafi ◽  
P. L. Couillard ◽  
A. Pandya ◽  
N. Shobha ◽  
W. F. Morrish ◽  
...  
Keyword(s):  
The Elderly ◽  
Carotid Stenting ◽  
Complication Rates ◽  
Carotid Angioplasty ◽  
Short Term ◽  
The Mean ◽  
Complications Rate ◽  
Angioplasty And Stenting ◽  
Carotid Angioplasty And Stenting ◽  
Length Of Hospitalization

Objective:Octogenarians were excluded from participation in many carotid endarterectomy trials due to the high complication rates observed in past studies. However, stroke resulting from carotid stenosis is expected to increase with the aging population. Moreover, advances in Carotid Angioplasty and Stenting (CAS) techniques have resulted in perceived improved safety of this procedure. We sought to review our experience with carotid stenting in symptomatic octogenarians with an emphasis on short-term outcomes and complications.Methods:This is a retrospective longitudinal cohort study of all symptomatic patients who underwent CAS in our center between 1997 and 2007. Thirty-day stroke and death rates, and length of hospitalization were compared between the symptomatic octogenarians and non-octogenarians.Results:A total of 214 procedures were performed on 211 symptomatic patients (56 females). Fifty-nine patients (14 females) were octogenarians. The median (interquartile range) age on procedure date for the octogenarian cohort was 83 (4) years. Periprocedural death occurred in two (3.4%) octogenarians and five (3.3%) non-octogenarians (p = 0.97). At 30 days from the procedure, stroke occurred in four (6.8%) octogenarians and seven (4.6%) non-octogenarians (p= 0.52). The mean hospital stay (4.8 days) was not different between the two cohorts. Age was not a predictor of the 30-day risk of composite stroke or death.Conclusion:The complications rate observed in octogenarians was not significantly higher than non-octogenarians. Our findings suggest that octogenarians should be included in randomized trials examining CAS to better define the risk-benefit profile of this procedure in the elderly.

Transcervical Approach With Protective Flow Reversal for Carotid Angioplasty and Stenting

2005 ◽  
Vol 12 (4) ◽  
pp. 446-453 ◽  
Author(s):  
Iraklis I. Pipinos ◽  
Jason M. Johanning ◽  
Chinh N. Pham ◽  
Krishnasamy Soundararajan ◽  
Thomas G. Lynch
Keyword(s):  
Flow Reversal ◽  
Carotid Angioplasty ◽  
Transcervical Approach ◽  
Angioplasty And Stenting ◽  
Carotid Angioplasty And Stenting
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