Angiographic patterns and the procedural and clinical outcomes achieved by proximal balloon occlusion in Symptomatic Carotid Artery Stenosis Stenting - 29/03/19
, Mehdi Mahmoudi, MD 1, Matteo Cappucci, MD 1, François-Louis Collemiche 1, Julien Labreuche, BST 2, Othmane Habza, Pharm.D 1, Grégory Gascou, MD 1, Pierre-Henri Lefèvre 1, Omer Eker, MD, PhD 1, Isabelle Mourand, MD 3, Nicolas Gaillard, MD 3, Mahmoud Charif, MD 3, Imad Derraz, MD, MSc 1, Caroline Arquizan, MD 3, Vincent Costalat, MD, PhD 1Resumen |
Background and purpose |
The best embolic protection strategy has not yet been established for carotid-artery stenting (CAS). We report here a new simplified approach using a balloon guiding catheter, inspired by stroke therapy, in patients harboring symptomatic ICA atherosclerotic stenosis or web. In addition, we describe the 3 angiographic patterns and clinical outcomes associated with this technique, called the simple flow blockage (SFB) technique.
Materials and methods |
This is a retrospective study with data extraction from a monocentric prospective clinical registry of consecutive patients admitted for symptomatic ICA stenosis or web. The primary study outcome (composite endpoint) was the rate of occurrence of death, symptomatic stroke or acute coronary syndrome within 30 days of intervention.
Results |
Seventy-five symptomatic patients with>50% carotid artery atherosclerotic stenosis or web were included. All procedures were successfully performed. The composite endpoint occurred in 3 patients (4.0%, 95%CI, 0.0 to 11.3): 1 had symptomatic ischemic stroke, 1 had reperfusion syndrome with symptomatic intracranial hemorrhage and 1 had acute coronary syndrome. Three angiographic patterns after proximal balloon inflation were observed: complete contrast column stagnation in the ICA (38.7%), retrograde washout of the ICA from the intracranial circulation towards the external carotid artery (35.5%), antegrade washout of contrast medium towards the intracranial circulation (25.8%). The median procedure length was 40minutes. New asymptomatic ischemic lesions were observed in 22.5% on DWI-MRI.
Conclusion |
The SFB technique allows fast and safe procedures in CAS. A favorable angiographic pattern after proximal balloon inflation was observed in 74.2% of cases.
El texto completo de este artículo está disponible en PDF.Esquema
Vol 46 - N° 2
P. 65 - mars 2019 Regresar al número
Artículo precedente
- Comparison of mono versus biplane performance and factors associated with higher radiation doses and contrast exposure during cerebrovascular mechanical thrombectomy, an international multi-centers study
- Adrien Guenego, Pascal J. Mosimann, Vitor Mendes Pereira, Kevin Zuber, Jean Albert Lotterie, Dobrocky Tomas, Patrick Nicholson, David Marcellus, Jean-Marc Olivot, N. Nestor Gonzalez, Michel Piotin, Fabrice Bonneville, Jan Gralla, Max Wintermark, Jeremy Heit, Christophe Cognard
- Malformations arterio-veineuses thalamiques : modes de présentation clinique, angio-architecture et prise en charge thérapeutique
- Mariette Delaître, Eimad Shotar, Bertrand Mathon, Nader Sourour, Aurélien Nouet, Pierre-Yves Borius, Stéphanie Lenck, Vincent Degos, Alexandre Carpentier, Frédéric Clarençon
Bienvenido a EM-consulte, la referencia de los profesionales de la salud.
El acceso al texto completo de este artículo requiere una suscripción.
¿Ya suscrito a @@106933@@ revista ?