Carotid artery stenting: Results and long-term follow-up

Gupta, Arun Kumar; Purkayastha, S.; Kapilamoorthy, Tirur Raman; Nair, Muralidharan; Thamburaj, Krishnamoorthy; Rupa, Sharmin Akhtar; Kesavadas, Chandrasekharan; Bodhey, Narendra Kuber

doi:10.4103/0028-3886.24711

Cited by 13 publications

(4 citation statements)

References 31 publications

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“…[16][17][18] The data on the rate of periproce-dural complications amongst Indian patients during CAS is scarce. One study by Gupta et al 19 reported a periprocedural mortality rate of around 8. 1% and minor stroke of about 4.…”

Section: Discussionmentioning

confidence: 99%

Carotid Artery Stenting and Its Impact on Cognitive Function: A Prospective Observational Study

et al. 2020

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Purpose: Carotid artery stenting (CAS) has evolved as a first-line therapeutic option for carotid revascularization in indicated patients for stroke prevention, but there is still a lack of data on its effect on cognitive function (CF), especially among Indian patients. To determine the effect of CAS on CF and to study the immediate and delayed complications of CAS in Indian patients.Materials and Methods: This was a prospective, observational, single-center study. CF was assessed using Addenbrooke’s cognitive examination version III (ACE) before and 3 months after stenting. The demographic and clinical parameters were also assessed. A follow-up evaluation after 3 months was done to compare CF and to observe the occurrence of any complications.Results: Out of 31 patients, 3 were lost to follow up. There were no immediate or delayed procedure-related complications. There was a statistically significant improvement in overall ACE score and memory before and after stenting. On subgroup analysis of those with and without strokes, there was a significant improvement in visuospatial function and mean ACE score. Those with left CAS had significant improvement in memory, visuospatial, language, and ACE scores than right CAS.Conclusion: CAS was associated with significant improvement in CF in patients.

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Section: Discussionmentioning

confidence: 99%

Carotid Artery Stenting and Its Impact on Cognitive Function: A Prospective Observational Study

et al. 2020

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“…Gupta et al (2006) describe such a case in an adult with good outcome [18]. Other authors consider the indications to early and delayed exploration giving examples of effects of the presence of bony fragments or foreign agents retained within the vertebral canal [19, 29, 54, 66, 70].…”

Section: Discussion and Literature Reviewmentioning

confidence: 99%

Pediatric arrowshot injury to cervical spinal cord-sagittal cord transection with no neurological deficit and good outcome: case report and review of literature

Skadorwa

Ciszek

2013

Childs Nerv Syst

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BackgroundPenetrating spinal cord injuries (PSCI) in cervical region are extremely rare in children. They mostly occur in a mechanism of a gunshot or a stab injury with the use of sharp objects. Gunshot injuries are usually fatal or end up with tetraplegia. Stab wounds may be less severe and result in partial neurological syndrome. In the management of PSCI in children, reliable diagnostics and history of the patient are the most valuable for further decisions, which include early or delayed exploration either nonsurgical treatment. There exist no clear algorithm for antibiotic use in pediatric population—it depends on the site of an injury, presence of pathological secretion from the wound, and nature of the trauma. The use of steroids is controversial. The most common complications related to surgery include infections, edema, and hemorrhage. They may also be associated with the migration of small residual microtraumatizing agent. The literature lacks algorithms for management in children.DiscussionIn this paper, an unusual case of almost total sagittal cervical cord transection is reported. The patient had no neurological symptoms and recovered with no complications. Diagnostic imaging on admission included X-ray and computed tomography. The patient underwent early surgical intervention with removal of foreign body from the cord and subsequent dural suturing. In the paper, the role of detailed history taking, adequate imaging, and drugs administration is discussed. The choice of distinct strategies is analyzed, and a revised literature review is presented in order to unify the management algorithm for pediatric PSCI.

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“…Higher rates of combined death and stroke (12%) were reported by Gupta and his colleagues in their initial 48 procedures. 12 However, this group did not use distal protection devices in most of their procedures, which is thought to be advantageous in preventing the periprocedural stroke in CAS. 7 To date, Stenting and Angioplasty with Protection in Patients at High Risk for Endarterectomy (SAPPHIRE) 7 is the only randomized trial that showed the superiority of CAS over CEA in reducing the rates of perioperative death and stroke (12.6% for CEA and 5.8% for CAS) and death, stroke, or myocardial infarction (7.3% for CEA and 2.6% for CAS) when used in high-risk patients.…”

Section: Survivalmentioning

confidence: 99%

Carotid Artery Angioplasty and Stenting: Introduction of a New Technique Into an Established Vascular Surgery Center

Albacker

Nouh

Alabbad

et al. 2009

Vasc Endovascular Surg

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Restenosis and stroke were observed more frequently in our initial experience in patients undergoing carotid artery angioplasty and stenting compared with carotid endarterectomy patients during the same time period. These differences disappeared in high-risk patients. Further studies, to evaluate the effect of the learning curve on early results as well as follow-up for intermediate and long-term durability of carotid artery angioplasty and stenting in high-risk patients, are required.

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Carotid artery stenting: Results and long-term follow-up

Abstract: CAS is an effective treatment modality of symptomatic carotid artery disease but should be carefully done in high-risk groups having severe medical ailments and those having severe bilateral stenosis of the carotid arteries.

Cited by 13 publications

References 31 publications

Carotid Artery Stenting and Its Impact on Cognitive Function: A Prospective Observational Study

Carotid Artery Stenting and Its Impact on Cognitive Function: A Prospective Observational Study

Pediatric arrowshot injury to cervical spinal cord-sagittal cord transection with no neurological deficit and good outcome: case report and review of literature

Carotid Artery Angioplasty and Stenting: Introduction of a New Technique Into an Established Vascular Surgery Center

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