Retinal embolization after carotid endarterectomy and stenting for carotid artery stenosis

Song, Gang; Sun, Ran; Chen, Yan Fei; Ma, Yan; Wang, Ya Bing; Li, Jiao; Li, Feng

doi:10.1016/j.jocn.2015.01.033

Cited by 9 publications

(8 citation statements)

References 15 publications

(23 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The incidence of RAO after CAS varies across reports, of which there are few. Song et al (2) reported a 4.9% rate of RAO in their CEA group (n = 61), unlike the much higher 16.9% rate in their CAS group (n = 71) ( p = 0.031). In the aftermath of CAS, 12 patients exhibited RAO, but only a single patient experienced diminished visual acuity or visual field (incidence of symptomatic RAO, 1.4%).…”

Section: Discussionmentioning

confidence: 88%

“…However, CAS is encumbered by a high incidence of emboli shed into the distal vascular bed. Such emboli result from plaque manipulation by guide wires, balloon inflation, and stent placement (12).…”

Section: Introductionmentioning

confidence: 99%

“…The retinal artery is a terminal artery without any anastomosis among branches and is the only source of nutrition for the inner retina. RAO and the corresponding loss of blood supply can impair visual acuity and visual fields or cause blindness in severe cases (2). This particular complication may thus be disabling and can substantially increase socioeconomic burdens.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Symptomatic Retinal Artery Occlusion after Angioplasty and Stenting of the Carotid Artery: Incidence and Related Risk Factors

Cho

Lee

et al. 2019

Korean J Radiol

View full text Add to dashboard Cite

ObjectiveRetinal artery occlusion (RAO) is rarely seen as a complication in patients undergoing carotid artery stenting (CAS); hence, its characteristics have not been documented in detail. This study aimed to investigate the incidence of this complication and the related risk factors, focusing on differences in ophthalmic artery (OA) supply (whether by the external or internal carotid artery [ECA or ICA]) prior to CAS procedures.Materials and MethodsWe retrospectively examined 342 patients who underwent CAS for severe and/or symptomatic carotid artery stenosis between January 2009 and December 2017. Cumulative medical records and radiologic data were assessed. RAO was confirmed by photography and fluorescent angiography of the fundus, which were performed by an ophthalmologist. In all patients, distal filter systems of various types were applied as cerebral protection devices (CPDs) during procedures. Univariate and multivariate analyses were conducted to identify the risk factors for RAO after CAS.ResultsSymptomatic RAO was observed in six patients (1.8%), of which five (6.8%) were ECA-dominant group members (n = 74). In a binary logistic regression analysis, OA supply by the ECA (odds ratio [OR], 9.705; 95% confidence interval [CI], 1.519–62.017; p = 0.016) and older age (OR, 1.159; 95% CI, 1.005–1.336; p = 0.041) were identified as significant risk factors in patients with RAO after CAS. ECA-supplied OA was also associated with the severity of ipsilateral ICA stenosis (p = 0.001) and ulcerative plaque (p = 0.021).ConclusionIn procedures performed using ICA distal filtering CPD systems, RAO as a complication of CAS (performed for severe stenosis) showed a relationship to ECA-supplied OA. For older patients, simultaneous use of ICA-ECA CPDs might help prevent such complications.

show abstract

Section: Discussionmentioning

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Symptomatic Retinal Artery Occlusion after Angioplasty and Stenting of the Carotid Artery: Incidence and Related Risk Factors

Cho

Lee

et al. 2019

Korean J Radiol

View full text Add to dashboard Cite

show abstract

“…Retinal artery occlusion (RAO) has also been known to occur in CAS, and various causes have been reported. [4][5][6][7][8][9] According to previous reports, the prevalence of all retinal artery embolisation during CAS is 5-16.9% and that of symptomatic RAO is 1.4-1.7%. 5,7,8 Thus central RAO and branch RAO are not rare complications of CAS; these are very severe complications because they are difficult to treat and result in a decline in activities of daily living caused by the irreversible visual disturbance.…”

Section: Introductionmentioning

confidence: 99%

Retinal artery occlusion during carotid artery stenting with distal embolic protection device

et al. 2018

View full text Add to dashboard Cite

Retinal artery occlusion associated with carotid artery stenosis is well known. Although it can also occur at the time of carotid artery stenting, retinal artery occlusion via the collateral circulation of the external carotid artery is rare. We encountered two cases of retinal artery occlusion that were thought to be caused by an embolus from the external carotid artery during carotid artery stenting with a distal embolic protection device for the internal carotid artery. A 71-year-old man presented with central retinal artery occlusion after carotid artery stenting using the Carotid Guardwire PS and a 77-year-old man presented with branch retinal artery occlusion after carotid artery stenting using the FilterWire EZ. Because additional new cerebral ischaemic lesions were not detected in either case by postoperative diffusion-weighted magnetic resonance imaging, it was highly likely that the debris that caused retinal artery occlusion passed through not the internal carotid artery but collaterals to retinal arteries from the external carotid artery, which was not protected by a distal embolic protection device. It is suggested that a distal protection device for the internal carotid artery alone cannot prevent retinal artery embolisation during carotid artery stenting and protection of the external carotid artery is important to avoid retinal artery occlusion.

show abstract

“…Retinal emboli and retinal artery occlusions are known to occur following greater arterial circulation procedures, including left ventricular assisted device surgery, coronary artery bypass graft surgery, carotid endarterectomy, and carotid artery stenting [ 1 - 2 ]. Pulmonary artery stenting is a rare procedure that may lead to central retinal artery occlusion.…”

Section: Introductionmentioning

confidence: 99%

Central Retinal Artery Occlusion with Sparing of Cilioretinal Artery Post Pulmonary Artery Stenting

Oo¹,

Zain²,

Shatriah³

2018

Cureus

View full text Add to dashboard Cite

show abstract

Retinal embolization after carotid endarterectomy and stenting for carotid artery stenosis

Cited by 9 publications

References 15 publications

Symptomatic Retinal Artery Occlusion after Angioplasty and Stenting of the Carotid Artery: Incidence and Related Risk Factors

Symptomatic Retinal Artery Occlusion after Angioplasty and Stenting of the Carotid Artery: Incidence and Related Risk Factors

Retinal artery occlusion during carotid artery stenting with distal embolic protection device

Central Retinal Artery Occlusion with Sparing of Cilioretinal Artery Post Pulmonary Artery Stenting

Contact Info

Product

Resources

About