Carotid Arterial Stenting

2017 ◽  
Author(s):  
Cordis ◽  
Keyword(s):  
Carotid Arterial ◽  
Arterial Stenting

Routine Use of Debris Aspiration Before Retrieval of Distal Filter Protection Devices in Carotid Arterial Stenting: Analysis of Captured Debris and Evaluation of Clinical Results

Neurosurgery ◽  
2010 ◽  
Vol 67 (5) ◽  
pp. 1260-1267 ◽  
Author(s):  
Takatoshi Sorimachi ◽  
Kazuhiko Nishino ◽  
Junsuke Shimbo ◽  
Kenichi Morita ◽  
Yasushi Ito ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Cerebral Arteries ◽  
Clinical Results ◽  
Debris Particles ◽  
Protection Systems ◽  
Protection Devices ◽  
Distal Filter ◽  
Carotid Arterial ◽  
Arterial Stenting ◽  
Method Group

Abstract BACKGROUND: Distal filter protection allows for continuous cerebral perfusion during carotid artery stenting (CAS), although a higher risk of debris migrating into the cerebral arteries compared with other protection systems has been reported. OBJECTIVE: To improve the extent of debris capture, we used routine aspiration of blood located proximal to the filter in the internal carotid artery blood column before retrieval of the filter device. METHODS: Of 71 CAS procedures with distal filter protection, routine aspiration was performed in 41 procedures. The size and number of debris particles in each aspirated blood sample were measured under a stereoscopic microscope in 30 consecutive procedures with routine aspiration. Occurrence of periprocedural neurological events was compared between 41 procedures with routine aspiration and the other 30 without routine aspiration. RESULTS: In the aspirated blood, debris particles ≥500 μm and ≥1000 μm in the longest diameter were observed in 30 (100%) and 28 (93.3%) procedures, respectively. The number of particles ≥1000 μm was significantly larger in the second through fourth blood aspirates vs the first aspirate (P < .05). Occurrence of periprocedural neurological events was significantly less frequent in the routine aspiration group (0 of 41 procedures) than in the conventional method group (7 of 30 procedures) (P < .05). CONCLUSION: The use of routine aspiration during CAS with distal filter protection possibly reduced periprocedural neurological events by increasing the proportion of debris captured. To improve the capture of debris particles, at least 4 repeated aspirations are advisable during each CAS procedure.

scholarly journals Comparative effectiveness of carotid arterial stenting versus endarterectomy

2009 ◽  
Vol 50 (5) ◽  
pp. 1040-1048 ◽  
Author(s):  
Peter W. Groeneveld ◽  
Lin Yang ◽  
Alexis Greenhut ◽  
Feifei Yang
Keyword(s):  
Comparative Effectiveness ◽  
Carotid Arterial ◽  
Arterial Stenting

scholarly journals Use of Embolic Protection Devices in Peripheral Interventions

2017 ◽  
Vol 12 (01) ◽  
pp. 31 ◽  
Author(s):  
Martin G Radvany ◽  
Keyword(s):  
Acute Coronary Syndromes ◽  
Peripheral Vascular ◽  
Bypass Grafts ◽  
Embolic Protection ◽  
Vein Bypass ◽  
Coronary Syndromes ◽  
Protection Devices ◽  
Carotid Arterial ◽  
Arterial Stenting ◽  
Distal Embolisation

The use of embolic protection devices (EPDs) when treating coronary saphenous vein bypass grafts, performing carotid arterial stenting and treating acute coronary syndromes is well accepted. We will review currently available devices and approaches to reduce distal embolisation, first discussing their uses in carotid interventions and then in vertebral and peripheral vascular interventions.

Monitoring of regional cerebral oxygenation by near-infrared spectroscopy in carotid arterial stenting: preliminary study

2005 ◽  
Vol 47 (5) ◽  
pp. 375-379 ◽  
Author(s):  
Nobutaka Horie ◽  
Naoki Kitagawa ◽  
Minoru Morikawa ◽  
Makio Kaminogo ◽  
Izumi Nagata
Keyword(s):  
Infrared Spectroscopy ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Cerebral Oxygenation ◽  
Preliminary Study ◽  
Carotid Arterial ◽  
Arterial Stenting

Systemic Effects of ADP-induced Platelet Aggregation and Their Modification by Aspirin and by Pyridinolcarbamate

1973 ◽  
Vol 30 (01) ◽  
pp. 178-190 ◽  
Author(s):  
Itsuro Kobayashi ◽  
Paul Didisheim
Keyword(s):  
Platelet Aggregation ◽  
Venous Pressure ◽  
Systemic Effects ◽  
Central Venous ◽  
Platelet Aggregates ◽  
Induced Changes ◽  
Second Wave ◽  
Carotid Arterial ◽  
Arterial Po2

SummaryADP, AMP, or ATP was injected rapidly intravenously in rats. ADP injection resulted in the f olio wing transient changes: a drop in platelet count, a rise in central venous pressure, a fall in carotid arterial PO2, bradycardia, arrhythmia, flutter-fibrillation, and arterial hypotension. AMP and ATP produced some of these same effects; but except for hypotension, their frequency and severity Avere much less than those following ADP.Prior intravenous administration of acetylsalicylic acid or pyridinolcarbamate, two inhibitors of the second wave of ADP-induced platelet aggregation in vitro, significantly reduced the frequency and severity of all the above ADP-induced changes except hypotension. These observations suggest that many of the changes (except hypotension) observed to follow ADP injection are produced by platelet aggregates which lodge transiently in various microcirculatory beds then rapidly disaggregate and recirculate.

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