Author(s): Cohen JE, Rajz G, Lylyk P, Hur TB, Gomori JM, et al.
Objective: The surgical treatment of radiation-induced carotid stenosis is challenging and presents a high rate of complications. This has led several investigators to propose stent-assisted angioplasty as the treatment of choice for this condition. The aim of this study is to evaluate the potential risks of intra-procedural embolic stroke in this setting using cerebral protection devices.
Methods: We describe our recent experience in the endovascular treatment by means of stent-assisted angioplasty with the aid of a filter cerebral protection device of eight patients presenting with radiation-induced carotid stenosis.
Results: Procedural success, defined as residual stenosis of less than 30% was obtained in all cases. The mean percentage stenosis was reduced from mean 80+/-6.3% (range 70-90%) to 13+/-4% (range 10-20%). Predilation was performed in five cases, post-dilation in all the cases. Mild-to-moderate bradycardia while inflating the balloon was present in three cases and was severe in one case. No patient sustained myocardial infarction, stroke or TIA during the procedure or hospital stay. During a mean clinical follow-up of 16+/-7.3 months (range 5-25) there were no neurological events. On sonographic follow-up, no patient presented in-stent de novo stenosis.
Discussion: Carotid angioplasty with cerebral protection can be performed safely in radiation-induced carotid stenosis with a high technical success rate. With the recent innovations and improvements in angioplasty technique, its indications and results will have to be redefined. Given the complexity and complications of surgical approaches for this condition, and the encouraging results obtained with endovascular techniques, carotid angioplasty emerges as the preferred treatment option.
Referred From: https://www.ncbi.nlm.nih.gov/pubmed/16197828
Author(s): Lam WW, Leung SF, So NM, Wong KS, Liu KH, et al.
Author(s): Elerding SC, Fernandez RN, Grotta JC, Lindberg RD, Causay LC, et al.
Author(s): Cheng SWK, Ting ACW, Lam LKL, Wei WI
Author(s): Ahuja A, Blatt GL, Guterman LR, Hopkins LN
Author(s): Ohta H, Sakai N, Nagata I, Sakai H, Higashi T, et al.
Author(s): Mubarak NA, Roubin GS, Iyer SS, Gomez CR, Liu MW, et al.
Author(s): Kim PH, Kadkhodayan Y, Derdeyn CP, Moran CJ
Author(s): Ting AC, Cheng SW, Yeung KM, Cheng PW, Lui WM, et al.
Author(s): Stein JS, Jacobson JH
Author(s): Becquemin JP, Gasparino LF, Etienne G
Author(s): Guthaner DF, Schmitz L
Author(s): Julius HJ, Murray GB
Author(s): Kretschmer G, Niederle B, Polterauer P, Waneck R
Author(s): Mellière D, Becquemin JP, Berrahal , Desgranges P, Cavillon
Author(s): Hans SS, Tuma
Author(s): Ragaz J, Jackson SM, Le N, Plenderleith IH, Spinelli JJ, et al.
Author(s): Overgaard M, Hansen PS, Overgaard J, Rose C, Andersson M, et al.
Author(s): Clarke M, Collins R, Darby S, Davies C, Elphinstone P, et al.
Author(s): Halle M, Gabrielsen A, Paulsson-Berne G, Gahm C, Agardh HE, et al.
Author(s): Zhao W, Robbins ME
Author(s): Gujral DM, Shah BN, Chahal NS, Senior R, Harrington KJ, et al.
Author(s): Fonkalsrud EW, Sanchez M, Zerubavel R, Mahoney A
Author(s): Cheng SW, Ting AC, Wu LL
Author(s): Atkinson JLD, SundtJr TM, Dale AJD, Cascino TL, Nichols DA
Author(s): Jones TR, Fuusha JD
Author(s): Kobayashi N, Nakagawa T, Tashiro K, Abe H