| A prospective evaluation of cerebral infarction following transcervical carotid stenting with carotid flow reversal. | |
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MedLine Citation:
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PMID: 20303806 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Cerebral embolisation constitutes the main source of complications during transfemoral carotid artery stenting (CAS) and is associated with a high incidence of silent brain infarction. The goal of this study is to evaluate the incidence of new ischaemic cerebral lesions following transcervical CAS with carotid flow reversal for neuroprotection. MATERIALS AND METHODS: Thirty-one consecutive patients underwent transcervical CAS with carotid flow reversal. A stroke scale and diffusion-weighted magnetic resonance imaging (DW-MRI) were performed within 24 h before and after the procedure. DW-MRI studies were compared blindly by two independent neuroradiologists. New hyper-intense DW signals were interpreted as ischaemic infarcts. The progress of all patients was followed for at least 30 days following intervention. RESULTS: All procedures were technically successful. Nineteen (61%) patients were symptomatic Mean carotid flow reversal time was 22 min. There were no major adverse events at 30 days. All patients remained neurologically intact without increase in the stroke scale. Thirty subjects had paired DW-MRI studies. Post-procedural DW-MRI ischaemic infarcts were found in four (12.5%) patients, all ipsilateral to the treated hemisphere and asymptomatic. During follow-up, all stents remained patent and all patients remained stroke-free. CONCLUSIONS: These data suggest that transcervical carotid stenting with carotid flow reversal carries a low incidence of new ischaemic infarcts, significantly lower than that reported with transfemoral CAS. The transcervical approach with carotid flow reversal may improve the safety of CAS and has the potential to produce results comparable to those of carotid endarterectomy. |
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Authors:
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J I Leal; A Orgaz; J Fontcuberta; A Flores; M Doblas; J M Garcia-Benassi; B Lane; C Loh; E Criado |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't Date: 2010-03-19 |
Journal Detail:
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Title: European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery Volume: 39 ISSN: 1532-2165 ISO Abbreviation: Eur J Vasc Endovasc Surg Publication Date: 2010 Jun |
Date Detail:
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Created Date: 2010-07-08 Completed Date: 2010-08-17 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9512728 Medline TA: Eur J Vasc Endovasc Surg Country: England |
Other Details:
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Languages: eng Pagination: 661-6 Citation Subset: IM |
Copyright Information:
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Copyright (c) 2010 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved. |
Affiliation:
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Vascular Surgery Section, Complejo Hospitalario de Toledo, Toledo, Spain. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Angiography Blood Vessel Prosthesis Implantation / methods* Carotid Artery, Common* Carotid Stenosis / diagnosis, physiopathology, surgery* Cerebral Infarction / diagnosis, epidemiology, etiology* Cerebrovascular Circulation Diffusion Magnetic Resonance Imaging Female Follow-Up Studies Humans Incidence Male Prospective Studies Regional Blood Flow Risk Assessment Risk Factors Stents / adverse effects* Treatment Outcome |
| Comments/Corrections | |
Comment In:
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Eur J Vasc Endovasc Surg. 2010 Jun;39(6):667
[PMID:
20381386
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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