Impact of calcified plaque volume on technical and 3-year outcomes after transcarotid artery revascularization

Grafmuller, Leanne E.; Lehane, Daniel J.; Dohring, Christian L.; Zottola, Zachary R.; Mix, Doran; Newhall, Karina; Doyle, Adam J.; Balceniuk, Mark D.

doi:10.1016/j.jvs.2023.03.017

Cited by 7 publications

(3 citation statements)

References 32 publications

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“…High rates of carotid plaque calcification are associated with high rates of residual stenosis and restenosis. [ 8 ] Highly calcified carotid arteries are a risk factor for stroke and major adverse events after CAS. [ 1 ] To achieve adequate stent expansion in severely calcified lesions, the radial force applied during balloon angioplasty must surpass the resistance posed by calcifications.…”

Section: Discussionmentioning

confidence: 99%

“…Managing calcified lesions using traditional angioplasty balloons can pose challenges due to limited lumen dilation, elevated dissection risks, and the need for repeated revascularization. [ 1 , 8 ] In the coronary artery, scoring balloons have been used for primary stenting of high-grade or concentrically calcified stenosis that is refractory to angioplasty with conventional angioplasty balloons. [ 2 , 3 , 6 , 18 ] The non-slip element (NSE) percutaneous transluminal angioplasty (PTA) balloon (Nipro Corporation, Osaka, Japan) is a low-profile, semi-compliant scoring balloon designed with three triangular nylon elements that can score even a stiff plaque wall, such as calcified plaque [ Figure 1a ].…”

Section: Introductionmentioning

confidence: 99%

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Usefulness of non-slip element percutaneous transluminal angioplasty scoring balloons in treating severe calcified lesions of the carotid artery for carotid artery stenting: A case report

Takase,

Tanaka,

Anai

et al. 2024

Surgical Neurology International

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Background: Treatment of calcified lesions with conventional angioplasty balloons can be difficult due to insufficient lumen expansion, high dissection rates, and repeated revascularization. We report a case in which a scoring balloon was used in lesions resistant to angioplasty with a semi-compliant balloon. Case Description: A 72-year-old man presented with severe stenosis and a highly calcified lesion in the right cervical internal carotid artery. Right carotid artery stenting (CAS) was planned to prevent future ischemic stroke events. Conventional semi-compliant balloon angioplasty was unsuccessful. Three inflations of a non-slip element (NSE) percutaneous transluminal angioplasty (PTA) scoring balloon (Nipro, Osaka, Japan) successfully achieved CAS without complications. Conclusion: This is the first report to describe the use of this scoring balloon in de novo carotid artery disease. NSE PTA scoring balloon catheters can be a useful option for refractory, highly calcified stenosis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Usefulness of non-slip element percutaneous transluminal angioplasty scoring balloons in treating severe calcified lesions of the carotid artery for carotid artery stenting: A case report

Takase,

Tanaka,

Anai

et al. 2024

Surgical Neurology International

View full text Add to dashboard Cite

show abstract

“… 8 , 19 The flow reversal technology also proves favorable for TCAR compared with TFCAS for heavily calcified lesions, because embolic protection is initiated before crossing the lesion for filter placement. 20 Heavy calcification was associated with a higher risk of adverse events in the ROADSTER (safety and efficacy study for reverse flow used during carotid artery stenting procedure) trials. However, in our experience, noncircumferential calcification tends to tolerate balloon angioplasty to the intended balloon size, often despite a heavy calcium burden.…”

Section: Discussionmentioning

confidence: 99%