Hostname: page-component-8448b6f56d-c4f8m Total loading time: 0 Render date: 2024-04-24T05:59:12.131Z Has data issue: false hasContentIssue false
  • English
  • Français

Carotid Stenting without Angioplasty

Published online by Cambridge University Press:  14 September 2018

S. Men ,
S.P. Lownie  and
D.M. Pelz
S. Men
Affiliation:
Department of Diagnostic Radiology, London Health Sciences Centre, University Campus, The University of Western Ontario, London, Ontario, Canada
S.P. Lownie
Affiliation:
Department of Diagnostic Radiology, London Health Sciences Centre, University Campus, The University of Western Ontario, London, Ontario, Canada
D.M. Pelz*
Affiliation:
Department of Diagnostic Radiology, London Health Sciences Centre, University Campus, The University of Western Ontario, London, Ontario, Canada
*
David M. Pelz, Department of Diagnostic Radiology, London Health Sciences Centre, University Campus, 339 Windermere Road, London, Ontario N6A 5A6
Rights & Permissions [Opens in a new window]

Abstract:

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Background:

Carotid angioplasty and stenting is gaining popularity as an alternative to carotid endarterectomy for the treatment of carotid bifurcation stenosis. The major concern with the procedure is the risk of embolic stroke which may be initiated by balloon angioplasty of friable atherosclerotic plaque. Elimination of angioplasty may result in a lower incidence of embolic complications.

Method:

We describe a case in which a self-expanding stent alone, without balloon angioplasty, was used to successfully dilate an atherosclerotic stenosis of the carotid bifurcation.

Results:

A moderate increase in vessel diameter, from 75% to 50%, was immediately observed after stent placement alone. No embolic complications were observed and follow-up plain film and ultrasound examinations showed progressive stent enlargement with excellent anatomic and hemodynamic results.

Conclusions:

In this case of severe carotid stenosis, the use of a self-expanding stent alone, without balloon angioplasty, resulted in excellent anatomic and hemodynamic improvement.

Résumé:

Résumé:Introduction:

L’angioplastie carotidienne et la mise en place d’une prothèse endovasculaire est une alternative de plus en plus populaire à l’endartérectomie carotidienne dans le traitement de sténoses de la bifurcation carotidienne. La préoccupation majeure associée à ce mode de traitement est le risque d’accident vasculaire cérébral embolique qui peut être déclenché par l’angioplastie par ballonnet de plaques athéroscléreuses friables.

Méthode:

Nous décrivons un cas chez qui seulement une prothèse endovasculaire auto-expansible, sans angioplastie, a été utilisée avec succès pour dilater une sténose athéroscléreuse de la bifurcation carotidienne.

Résultats:

Une augmentation modérée du diamètre du vaisseau, de 75% à 50%, a été observée immédiatement après l’insertion de la prothèse endovasculaire. Aucune complication embolique n’a été observée et on a noté un déploiement progressif de la prothèse avec d’excellents résultats anatomiques et hémodynamiques sur les radiographies simples et à l’échographie au cours du suivi.

Conclusions:

Chez ce cas de sténose carotidienne sévère, un excellent résultat anatomique et hémodynamique a été obtenu par la mise en place d’une prothèse endovasculaire, sans angioplastie.

Type
Case Reports
Information
Canadian Journal of Neurological Sciences , Volume 29 , Issue 2 , May 2002 , pp. 175 - 179
Copyright
Copyright © Canadian Neurological Sciences Federation 2002

References

1. Connors, JJ, Seidenwurm, D, Wojak, JC, et al. Treatment of atherosclerotic disease at the cervical carotid bifurcation: current status and review of the literature. AJNR Am J Neuroradiol 2000;21:444-450.Google Scholar
2. Theron, J, Courtheoux, P, Alachkar, F, et al. New triple coaxial catheter system for carotid angioplasty with cerebral protection. AJNR Am J Neuroradiol 1990;11:869-874.Google Scholar
3. Ferguson, RDG, Lee, LI, Connors, JJ, Ferguson, JG. Angioplasty in the extracranial and the intracranial vasculature. Semin Intervent Radiol 1994;2:64-82.CrossRefGoogle Scholar
4. Ferguson, GG, Eliasziw, ME, Barr, HWK, et al. The North American Symptomatic Carotid Endarterectomy Trial: surgical results in 1415 patients. Stroke 1999;30(9): 1751-1758.Google Scholar
5. Connors, JJ, Wojak, JC, Qian, Z. Tools of the trade. In: Connors III JJ, Wojak, JC (Eds). Interventional Neuroradiology: Strategies and Practical Techniques. WB Saunders, Philadelphia;1999:1-37.Google Scholar
6. Zollikofer, CL, Ferral, H, Cragg, AH, Castanada-Zuniga, WR, Amplatz, K. Mechanism of transluminal angioplasty. In: Castaneda-Zuniga, WR Ed. Interventional Radiology. London: Williams and Wilkins, 1997; 319-371.Google Scholar
7. Jordan, WD, Voellinger, DC, Doblar, DD, et al. Microemboli detected by transcranial Doppler monitoring in patients during carotid angioplasty versus carotid endarterectomy. Cardiovasc Surg 1999;7:33-38.CrossRefGoogle Scholar
8. Schwartz, RS. Pathophysiology of restenosis: interaction of thrombosis, hyperplasia, and/or remodeling. Am J Cardiol 1998;81(7A):14E-17E.Google Scholar
9. Edelman, ER, Rogers, C. Pathobiologic responses to stenting. Am J Cardiol 1998;81(7A):4E-6E.Google Scholar
10. Vorwerk, D, Redha, F, Neuerburg, J, Clerc, C, Gunther, RW. Neointima formation following arterial placement of self-expanding stents of different radial force: experimental results. Cardiovasc Interv Radiol 1994;17:27-32.Google Scholar
11. Men, S, Hekimoglu, B, Kaderoglu, H, et al. Palliation of malignant obstructive jaundice: use of self-expandable metal stents. Acta Radiol 1996;37:259-266.Google Scholar