Minimizing Complications of Carotid Stenting

Parodi, F. Ezequiel; Schönholz, Claudio; Parodi, Juan C.

doi:10.1177/1531003510380746

Cited by 11 publications

(9 citation statements)

References 20 publications

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“…Echolucent lesions are more likely to be associated with increased embolic risk, whereas recurrent stenoses or fibrous lesions are associated with a decreased risk of procedural embolization. 66,96,165,184 Stent predilation is not recommended unless a filter cannot be passed. Stent selection is often based on physician preference.…”

Section: B Carotid Artery Stentingmentioning

confidence: 98%

“…Specific recommendations on techniques to reduce complications of CEA and CAS are beyond the scope of this report and can be found elsewhere. 164,165 However, some general recommendations can be made regarding the conduct of CEA and CAS.…”

Section: Technical Recommendations For Carotid Interventionsmentioning

confidence: 99%

“…Direct comparison of proximal occlusion with flow reversal vs distal protection shows that proximal protection with flow reversal results in the lowest embolic load 165,185 However, no device can completely eliminate the risk of embolization during CAS. The fact that no embolic protection is completely effective and that some emboli originate during cannulation of the aortic arch and the proximal great vessels suggests that although improvements to embolization after CAS can be made, the problem cannot be eliminated.…”

Section: B Carotid Artery Stentingmentioning

confidence: 99%

See 2 more Smart Citations

Updated Society for Vascular Surgery guidelines for management of extracranial carotid disease

Ricotta

AbuRahma

Ascher

et al. 2011

Journal of Vascular Surgery

562

536

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Management of carotid bifurcation stenosis is a cornerstone of stroke prevention and has been the subject of extensive clinical investigation, including multiple controlled randomized trials. The appropriate treatment of patients with carotid bifurcation disease is of major interest to the community of vascular surgeons. In 2008, the Society for Vascular Surgery published guidelines for treatment of carotid artery disease. At the time, only one randomized trial, comparing carotid endarterectomy (CEA) and carotid stenting (CAS), had been published. Since that publication, four major randomized trials comparing CEA and CAS have been published, and the role of medical management has been re-emphasized. The current publication updates and expands the 2008 guidelines with specific emphasis on six areas: imaging in identification and characterization of carotid stenosis, medical therapy (as stand-alone management and also in conjunction with intervention in patients with carotid bifurcation stenosis), risk stratification to select patients for appropriate interventional management (CEA or CAS), technical standards for performing CEA and CAS, the relative roles of CEA and CAS, and management of unusual conditions associated with extracranial carotid pathology. Recommendations are made using the GRADE (Grades of Recommendation Assessment, Development and Evaluation) system, as has been done with other Society for Vascular Surgery guideline documents.[corrected] The perioperative risk of stroke and death in asymptomatic patients must be<3% to ensure benefit for the patient. CAS should be reserved for symptomatic patients with stenosis of 50% to 99% at high risk for CEA for anatomic or medical reasons. CAS is not recommended for asymptomatic patients at this time. Asymptomatic patients at high risk for intervention or with <3 years life expectancy should be considered for medical management as the first-line therapy.

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Section: B Carotid Artery Stentingmentioning

confidence: 98%

Section: Technical Recommendations For Carotid Interventionsmentioning

confidence: 99%

Section: B Carotid Artery Stentingmentioning

confidence: 99%

See 1 more Smart Citation

Updated Society for Vascular Surgery guidelines for management of extracranial carotid disease

Ricotta

AbuRahma

Ascher

et al. 2011

Journal of Vascular Surgery

562

536

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“…16,17 In the endovascular domain, this technology has been developed to improve the outcomes of carotid artery stenting (CAS) procedures, as large patient trials have clearly established the relationship between operator experience with CAS and patient outcomes. 18 Initial reports on patient-specific or procedure rehearsal already indicate that it is feasible to use this technology in daily practice, 19 that it resembles the real intervention, that it may be a valuable tool to guide the selection of appropriate endovascular tools, and that it can optimize the team preparation. 8,[20][21][22] This study set out to evaluate the hypothesis that patientspecific rehearsal is more effective than both a preoperative generic warm-up and no preparation at all, in enhancing the technical performance of physicians performing a simulated CAS intervention.…”

mentioning

confidence: 98%

Simulated Procedure Rehearsal Is More Effective Than a Preoperative Generic Warm-Up for Endovascular Procedures

Willaert

Aggarwal²,

Daruwalla³

et al. 2012

Annals of Surgery

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“…Данные эпизоды могут как сопровождаться нев-рологической симптоматикой, так и протекать бес-симптомно [21,[46][47][48].…”

Section: послеоперационные микроэмболические осложненияunclassified

Endovascular Treatment of Carotid Atherosclerosis: Concerns and Perspectives

Tvorogova

Bulgakova

Шукуров

et al. 2017

Racionalʹnaâ farmakoterapiâ v kardiologii

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1 Клиника «Семья». Россия 141730, Московская обл., Лобня, ул. Текстильная, 16 2 Государственный научно-исследовательский центр профилактической медицины Россия 101990, Москва, Петроверигский пер., 10Инсульт является одной из наиболее частых причин смерти и потери трудоспособности среди взрослого населения. Большинство ишемиче-ских инсультов обусловлено наличием атеросклеротического поражения внутренней сонной артерии. По сравнению с консервативной ме-дикаментозной терапией каротидная эндартерэктомия является более эффективной в профилактике инсультов у пациентов со стенозом сон-ной артерии. Стентирование сонной артерии также является широко распространенным методом лечения, однако, оно связано с большим количеством периоперационных осложнений. Знание факторов риска этих осложнений может повлиять на выбор тактики лечения пациен-та, однако эти факторы недостаточно изучены. Stroke is one of the most frequent causes of death and permanent disability among adults. The majority of ischemic strokes are due to atherosclerotic plaque in the internal carotid artery. Carotid endarterectomy is more effective than medical management in the prevention of stroke in patients with carotid artery stenosis. Carotid artery stenting, a less invasive revascularization strategy than endarterectomy, is also wide-spread but it is associated with more periprocedural complications. Knowledge of risk factors of these complications may impact treatment decisions for the individual patient, but these factors have not been extensively studied.Keywords: stroke, carotid artery disease, carotid angioplasty with stenting, complications, cerebral microemboli. ВведениеШирокое распространение нездорового образа жизни, с одной стороны, и успешная борьба с инфек-ционными заболеваниями, с другой, привели к тому, что основной задачей медицины начала XXI века ста-ла борьба с неинфекционными заболеваниями (НИЗ), ведущее место среди которых занимают болезни сер-дечно-сосудистой системы. В большинстве развитых стран мира острое нарушение мозгового кровообра-щения (ОНМК) лидирует среди причин нетрудоспо-собности взрослого населения и занимает второе или третье место в структуре смертности [1][2][3]. Несмотря на активное развитие системы оказания помощи больным с ОНМК, включающей тромболитическую, антикоагу-лянтную терапию и создание мультидисциплинарных бригад, краткосрочный и долгосрочный прогноз при ОНМК по-прежнему остается неблагоприятным. Это свя-зано как с высокой смертностью в острый период на-рушения мозгового кровообращения (в России -96-119 смертей на 100000 населения), так и с фор-мированием стойкой инвалидизации выживших боль-ных [2,4]. Таким образом, крайне актуальной остает-ся проблема разработки методов первичной и вто-ричной профилактики ОНМК. 80

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Minimizing Complications of Carotid Stenting

Cited by 11 publications

References 20 publications

Updated Society for Vascular Surgery guidelines for management of extracranial carotid disease

Updated Society for Vascular Surgery guidelines for management of extracranial carotid disease

Simulated Procedure Rehearsal Is More Effective Than a Preoperative Generic Warm-Up for Endovascular Procedures

Endovascular Treatment of Carotid Atherosclerosis: Concerns and Perspectives

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