scholarly journals The Surgical Approach for the High Cervical Internal Carotid Artery Stenosis in Carotid Endarterectomy

2013 ◽  
Vol 41 (2) ◽  
pp. 83-88 ◽  
Author(s):  
Taku SUGIYAMA ◽  
Ken KAZUMATA ◽  
Katsuyuki ASAOKA ◽  
Yuka YOKOYAMA ◽  
Koji ITAMOTO
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Carotid Endarterectomy ◽  
Surgical Approach ◽  
Carotid Artery Stenosis ◽  
Internal Carotid ◽  
Internal Carotid Artery Stenosis ◽  
Artery Stenosis ◽  
High Cervical ◽  
Cervical Internal Carotid Artery

scholarly journals Snare-Assisted Trans-Brachial Stenting for the Cervical Internal Carotid Artery Stenosis of Patient with Aorto-Iliac Occlusion

2006 ◽  
Vol 12 (1_suppl) ◽  
pp. 221-228
Author(s):  
H. Oowaki ◽  
N Matsuura ◽  
M. Ishikawa
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Stent Placement ◽  
Carotid Artery Stenosis ◽  
Internal Carotid ◽  
Internal Carotid Artery Stenosis ◽  
Artery Stenosis ◽  
Femoral Access ◽  
Cervical Internal Carotid Artery ◽  
Iliac Occlusion

We describe a case of endo-luminal stent placement with Snare-assist for a cervical internal carotid artery stenosis in which percutaneous access was obtained via the brachial artery. A 68-year-old man with known disease of the carotid, peripheral, and coronary arteries, with Human T-cell Lymphotrophic Virus type-1 (HTLV-1) Associated Myelopathy (HAM) presented for endoluminal revascularization of a severe, progressive right internal carotid artery stenosis, but with aorto-iliac occlusion. Transfemoral access was complicated by an aorto-iliac occlusion. A trans-brachial approach was successfully attempted, and a SMARTer stent (Cordis Endovascular, Miami Lakes, FL) was successfully placed through a 7-French Shuttle-SL guide sheath (Cook, Bloomington) under Snare-assist. The trans-brachial approach is becoming an increasingly viable alternative route for stent placement in patients with contra-indicated or complicated femoral access routes. As devices become increasingly more pliable and smaller, the trans-brachial route will be used with increasing frequency in the select patient population for stenting of both the cervical and intracranial circulation.

scholarly journals Staged Carotid Stenting and Carotid Endarterectomy for Bilateral Internal Carotid Artery Stenosis

2003 ◽  
Vol 9 (1_suppl) ◽  
pp. 143-148 ◽  
Author(s):  
H. Fukuda ◽  
K. Iihara ◽  
N. Sakai ◽  
K. Murao ◽  
H. Sakai ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Carotid Endarterectomy ◽  
Complication Rate ◽  
Carotid Artery Stenosis ◽  
Internal Carotid ◽  
Carotid Stenting ◽  
Internal Carotid Artery Stenosis ◽  
Artery Stenosis ◽  
Minor Stroke

The purpose of this study was to evaluate the efficacy and safety of staged carotid stenting (CS) and carotid endarterectomy (CEA) for bilateral internal carotid artery stenosis. With this strategy, initial carotid stenting was performed for the high grade carotid stenosis to reduce the risk of subsequent CEA. Eight patients were treated with staged CS and CEA; CS for asymptomatic side followed by CEA for symptomatic side. Sufficient revascularization was obtained in all procedures but one CS procedure. Two minor stroke caused by distal embolism occurred during the perioperative period of CS. Postprocedural persistent hypotension was observed in one CS procedure. The mean interval between CS and CEA was 19.8 days. In conclusion, although our strategy has some advantages such as avoidance of bilateral cranial nerve palsy and shorter admission period over staged CEA, relatively high complication rate was noted at the first CS without any stroke morbidity post CEA. Our preliminary result showed that further reduction of periprocedural complication rate at the initial stenting is mandatory for this approach justified.

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