Document Detail


Safe carotid artery angioplasty and stenting in patients unsuitable for transfemoral approach.
MedLine Citation:
PMID:  20224530     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: The aim of this study was to use the maximum of all the protective measures to make carotid angioplasty and stenting (CAS) a safe procedure. METHODS: Twenty patients with severe carotid disease have been treated. These patients were considered as high risk for carotid endarterectomy and not suitable for transfemoral CAS for anatomic reasons. Transcervical approach to the common carotid (CCA) and the internal jungular vein (IJV) has been used. The vessels were cannulated with introducing sheaths and the flow in the internal carotid (ICA) was reversed by occluding the proximal CCA and creating a fistula with the IJV by connecting the two sheaths. The carotid lesion was crossed under retrograde flow and a filter was positioned and opened in the distal ICA. Antegrade flow was then resumed and CAS was performed. RESULTS: All procedures were successful and uneventful with the exception of transient hypotension in 3 patients. The mean time of flow reversal was less than 1.5 min. Seventeen patients were discharged the following morning and 3 on the subsequent day, because of hypotension. CONCLUSION: The results of this preliminary study indicate that the combination of several protective measures for CAS is effective. Further series are required to confirm our findings.
Authors:
D Christopoulos; E Philippov; M Kallintzi
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International angiology : a journal of the International Union of Angiology     Volume:  29     ISSN:  1827-1839     ISO Abbreviation:  Int Angiol     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-03-12     Completed Date:  2010-07-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8402693     Medline TA:  Int Angiol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  37-40     Citation Subset:  IM    
Affiliation:
Division of Vascular Surgery, B' Surgical Unit, G. Gennimatas Hospital, University of Thessaloniki Medical School, Thessaloniki, Greece. dechrist@otenet.gr
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Angioplasty / adverse effects,  instrumentation*,  methods
Arteriovenous Shunt, Surgical
Carotid Stenosis / physiopathology,  radiography,  therapy*
Female
Femoral Artery
Filtration / instrumentation
Humans
Hypotension / etiology
Length of Stay
Male
Pilot Projects
Regional Blood Flow
Risk Assessment
Severity of Illness Index
Stents*
Time Factors
Tomography, X-Ray Computed
Treatment Outcome

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