Fate of the external carotid artery following carotid interventions

Casey, Kevin; Wei, Zhou; Tedesco, Maureen M.; Al-Khatib, Weesam K.; Hernandez‐Boussard, Tina; Bech, Fritz

doi:10.1055/s-0031-1278348

Cited by 4 publications

(13 citation statements)

References 16 publications

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“…In this series, all patients with poststenting ECA stenosis were asymptomatic as well. 6 Brewster et al did not look at stenosis but had an occlusion rate of 3.8%. Despite having a large amount of patients and longterm follow-up, they did not identify any patients with an ECA and ICA stenosis further showing that this is very uncommon.…”

Section: Discussionmentioning

confidence: 99%

“…13 Some studies have used ECA/CCA ratio as a measure of ECA stenosis; however, this has not been validated as it has for the ICA. 6 We did however include it as a comparison to our criteria. We also used a 2-fold increase in PSV as the cutoff for a significant change in the velocity pre-and poststenting.…”

Section: Methodsmentioning

confidence: 99%

“…ECA stenosis can occur in 5e11% of cases after carotid endarterectomy. 5,6 In contrast, higher rates of stenosis and progression of preexisting stenosis have been seen in the ECA after ICA stenting; however, the rates of occlusion remain low. 6e8 In other studies, patients who underwent carotid stenting were observed to have a significantly greater mean increase in peak systolic velocities (PSVs) of the ECA and higher rate of occlusion when compared with patients who underwent open carotid procedures.…”

Section: Introductionmentioning

confidence: 99%

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External Carotid Artery Stenosis after Internal and Common Carotid Stenting

Siracuse

Epelboym

et al. 2015

Annals of Vascular Surgery

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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External Carotid Artery Stenosis after Internal and Common Carotid Stenting

Siracuse

Epelboym

et al. 2015

Annals of Vascular Surgery

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“…The carotid bifurcation consists of external carotid artery (ECA), internal carotid artery (ICA), and common carotid artery (CCA). Early clinical studies demonstrated that atherosclerotic lesions in the carotid bifurcations usually developed at the distal CCA and the proximal ICA [1][2][3]. The intervention, a breakthrough treatment for occlusive vascular disease, becomes an effective and widely used therapy, especially for carotid bifurcation lesions.…”

mentioning

confidence: 99%

“…The implanted stent usually covers the segment of ICA or CCA because of atherosclerotic lesions. Interestingly, ipsilateral ECA after stenting in the carotid bifurcation presents a high risk of occlusive disease [1][2][3]. The trial included 312 patients in Netherlands found that more than 50% of stenosis in ipsilateral ECA emerged after carotid stenting [7].…”

mentioning

confidence: 99%

Hemodynamic Impact of Stenting on Carotid Bifurcation: A Potential Role in the Stented Segment and External Carotid Artery

Fan

Liu

Zhang

et al. 2021

Preprint

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Carotid stenting near the bifurcation carina is associated with adverse events, especially in-stent restenosis, in-stent thrombosis, and side branch occlusion in clinical data. This study aims to determine the potential biomechanical mechanisms for these adverse events after carotid stenting. The patient-specific carotid models were constructed with different stenting scenarios to study the flow distribution and hemodynamic parameters, such as wall shear stress (WSS), flow velocity, relative residence time (RRT), and oscillating shear index (OSI) in the carotid bifurcation. The results suggested that existing stent obviously reduced blood flow to external carotid artery (ECA) but enhanced local flow disturbance both in ECA and stented internal carotid artery (ICA), and the inner-posterior wall of stented ICA and the outer-posterior wall of ECA might endure a relatively low level of WSS and remarkably elevated OSI and RRT. In addition, the implanted stent leads to more ECA adverse flow than stented ICA. While disturbed flow in the vicinity of strut increased as stent length increased, blood flow and areas of local flow disturbance in ECA slightly decreased as stent length increased. In conclusion, the results revealed that ECA might be in relatively high levels of abnormal local hemodynamics after stenting, followed by stented ICA, leading to potential adverse events after interventions.

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Hemodynamic Impact of Stenting on Carotid Bifurcation: A Potential Role of the Stented Segment and External Carotid Artery

Fan

Liu

Zhang

et al. 2021

Computational and Mathematical Methods in Medicine

View full text Add to dashboard Cite

Carotid stenting near the bifurcation carina is associated with adverse events, especially in-stent restenosis, thrombosis, and side branch occlusion in clinical data. This study is aimed at determining the potential biomechanical mechanisms for these adverse events after carotid stenting. The patient-specific carotid models were constructed with different stenting scenarios to study the flow distribution and hemodynamic parameters, such as wall shear stress (WSS), flow velocity, relative residence time (RRT), and oscillating shear index (OSI) in the carotid bifurcation. The results suggested that the existing stents surely reduced blood flow to the external carotid artery (ECA) but enhanced local flow disturbance both in ECA and stented internal carotid artery (ICA), and the inner posterior wall of the stented ICA and the outer posterior wall of ECA might endure a relatively low level of WSS and remarkably elevated OSI and RRT. In addition, the implanted stent leads to more ECA adverse flow than ICA after stenting. While disturbed flow near the strut increased as stent length increased, blood flow and areas of local flow disturbance in ECA slightly decreased as stent length increased. In conclusion, the results revealed that ECA might be in relatively high levels of abnormal local hemodynamics after stenting, followed by stented ICA, leading to potential adverse events after intervention.

show abstract

Fate of the external carotid artery following carotid interventions

Cited by 4 publications

References 16 publications

External Carotid Artery Stenosis after Internal and Common Carotid Stenting

External Carotid Artery Stenosis after Internal and Common Carotid Stenting

Hemodynamic Impact of Stenting on Carotid Bifurcation: A Potential Role in the Stented Segment and External Carotid Artery

Hemodynamic Impact of Stenting on Carotid Bifurcation: A Potential Role of the Stented Segment and External Carotid Artery

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