Mechanical Thrombectomy of Symptomatic Acute Carotid Stent Thrombosis Using Transcarotid Artery Revascularization Neuroprotection Flow Reversal Technique

Mouawad, Nicolas J.; Hui, Samuel

doi:10.1016/j.avsg.2020.05.054

Cited by 5 publications

(3 citation statements)

References 17 publications

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“… 8 , 9 , 10 Parodi et al 11 described the first flow-reversal technique for thrombotic carotid intervention in 2005 using his novel system, and other investigators have described using the ENROUTE system for nonocclusive carotid thrombus intervention. 12 , 13 , 14 …”

Section: Discussionmentioning

confidence: 99%

Rescue of immediate post-transcarotid artery revascularization carotid stent thrombosis due to clopidogrel resistance using flow-reversal and aspiration thrombectomy

2023

Journal of Vascular Surgery Cases, Innovations and Techniques

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Section: Discussionmentioning

confidence: 99%

Rescue of immediate post-transcarotid artery revascularization carotid stent thrombosis due to clopidogrel resistance using flow-reversal and aspiration thrombectomy

2023

Journal of Vascular Surgery Cases, Innovations and Techniques

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“…Endarterectomy and thrombosed stent removal ensure rapid restoration of cerebral blood flow and reduce the risk of recurrence; several cases of urgent stent removal with favorable results have been demonstrated in previous studies (20,21); however, endarterectomy might lead to hyperperfusion syndrome and local hematoma. Mechanical thrombectomy is another potential therapy method (22). The difficulty of thrombectomy for CST is that the microguidewire needs to pass through the thrombus to avoid passing between the stent and the vascular wall.…”

Section: Discussionmentioning

confidence: 99%

Mechanical thrombectomy for symptomatic stent thrombosis after carotid artery stenting

Fan,

Liu,

Xue

2023

Front. Neurol.

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BackgroundAs there is still no consensus on the treatment of carotid stent thrombosis (CST), we would like to describe our experience with the revascularization of CST by mechanical thrombectomy.MethodsWe retrospectively studied patients who underwent mechanical thrombectomy after CST at Xuzhou Municipal First People’s Hospital and Xuzhou Central Hospital between January 2020 and November 2022. The results of the procedures, complications, and clinical and imaging follow-up were recorded.ResultsA total of six patients were included in this study. The stenosis grade before stent implantation was ≥85% in all patients, and the stenosis length ranged from 7 to 20 mm. Patients experienced CST within 6 days to 45 months after carotid artery stenting (CAS); the median admission on the National Institutes of Health Stroke Scale (NIHSS) at CST was 12 (range 8–25). Mechanical thrombectomy was successfully performed in all patients. There was no periprocedural death, and the modified Rankin Scale (mRS) at the 3-month follow-up was 0–2. All patients showed recovery from their neurological deficits.ConclusionThe treatment of symptomatic CST with mechanical thrombectomy resulted in satisfactory clinical outcomes. This regimen could be effective and safe, and future prospective and randomized studies are warranted.

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“…Transcarotid artery revascularization transiently reverses blood flow intraoperatively to enhance neuroprotection during EVT. [ 22 ] Retriever wire supported carotid artery revascularization effectively and safely manages tandem occlusion patients with both extracranial and intracranial ICA lesions. [ 23 ] The ongoing thrombectomy in tandem occlusion trial is investigating EVT alone compared to EVT with concomitant extracranial carotid stenting.…”

Section: Current Horizons Of Endovascular Mechanical Thrombectomymentioning

confidence: 99%

Vascular tortuosity in endovascular mechanical thrombectomy

Farooq

Lee

2021

Brain Circ

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Endovascular mechanical thrombectomy effectively removes occlusive thrombi from the arterial lumen; however, there is little literature supporting the relevance of vascular geometry on surgical outcomes. Critical vessel characteristics including the degree of angulation and tortuosity influence the ability to advance stent retriever devices toward the site of occlusion. Therefore, it is crucial to evaluate the impact of carotid artery catheter pathway accessibility on the thrombectomy outcomes in acute ischemic stroke (AIS) patients. Traditional imaging modalities generate incomplete pictures of the vascular tortuosity and are prone to clinical judgment errors. Recent three-dimensional computed tomography angiography image analysis techniques circumvent these limitations to calculate accurate tortuosity and angulation measurements. These novel images facilitate classifying common anatomical variant patients into groups that may be treated with specially designed catheter devices. Importantly, this image analysis method reveals significant angulation in the common carotid artery and extracranial internal carotid artery that correlates with delays in reaching the occlusion site. Increased age, which is associated with increased risk of stroke, also increases the incidence of severe tortuosity. The semi-automated measurements technique also demonstrate that full 360° arterial loops are present in nearly 3% of catheter pathways and that the overall degree of angulation differs bilaterally. In this review, we examine the utility of this novel image analysis procedure and evaluate the recent literature relevant to neuroendovascular thrombectomy in AIS patients. Three literature databases – PubMed, Embase, and Web of Science were queried for original articles investigating both preclinical and clinical thrombectomy applications.

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Mechanical Thrombectomy of Symptomatic Acute Carotid Stent Thrombosis Using Transcarotid Artery Revascularization Neuroprotection Flow Reversal Technique

Cited by 5 publications

References 17 publications

Rescue of immediate post-transcarotid artery revascularization carotid stent thrombosis due to clopidogrel resistance using flow-reversal and aspiration thrombectomy

Rescue of immediate post-transcarotid artery revascularization carotid stent thrombosis due to clopidogrel resistance using flow-reversal and aspiration thrombectomy

Mechanical thrombectomy for symptomatic stent thrombosis after carotid artery stenting

Vascular tortuosity in endovascular mechanical thrombectomy

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