Topography of Vertebral Artery Origin Plaques: Characteristics and Determinants

Simonetto, Marialaura; DeSousa, Keith; Campo, Nelly; Pandey, Vikas; Koch, Sebastian

doi:10.1002/jum.14692

Cited by 3 publications

(2 citation statements)

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“…With respect to the pathogenesis of this process, early ISR (<6 weeks) is caused by myointimal hyperplasia and vascular remodeling, and late ISR is a consequence of recurrent neoatherosclerosis (19,20). Compared with VA plaques, ICA plaques were more prone to eccentric lesions; this was largely due to less shear stress on the lateral wall, where most plaques occurred (21,22). Stent fracture has also been previously reported to predict plaque formation due to abnormal endothelial proliferation caused by mechanical disruption of the fracture.…”

Section: Discussionmentioning

confidence: 99%

Hybrid Recanalization for the Treatment of Carotid/Vertebral In-stent Restenosis or Occlusion: Pilot Surgery Experiences From One Single Center

et al. 2020

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Background : The hybrid recanalization of internal carotid artery (ICA) and vertebral artery (VA) in-stent restenosis or occlusion using a combination of endarterectomy and endovascular intervention has achieved technical success. We present our surgical experiences to further evaluate the safety and efficacy of the hybrid technique for the treatment of in-stent restenosis and occlusion.Methods : A cohort of 12 refractory patients with in-stent restenosis or occlusion who underwent hybrid recanalization, a combination of endarterectomy and endovascular intervention, were retrospectively analyzed. Medical records, including presenting symptoms, comorbidities, contralateral ICA/VA findings, use of antiplatelet drugs, postoperative complications, and angiographic outcomes, were collected.Results : Among 415 consecutive patients with ICA, common carotid artery, and V1 segment lesions, 12 refractory patients (2.89%) with 13 cases were enrolled in our study (1 female and 11 male). All patients underwent successful hybrid recanalization. There were no cases of postoperative stroke or death. Only two patients sustained hoarseness, but it resolved within 2 weeks after surgery. Three patients were treated with dual antiplatelet (aspirin and clopidogrel), seven with single antiplatelet (aspirin), one with single antiplatelet (clopidogrel), and one with single antiplatelet (ticagrelor). All patients were followed up in the outpatient department according to the protocol, with a mean follow-up period of 13 months (range, 6–24 months). No death or recurrent symptoms occurred during the regular follow-up period.Conclusion : The hybrid technique maybe a safe and feasible treatment option to recanalize in-stent restenosis or occlusion with acceptable complications.

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Section: Discussionmentioning

confidence: 99%

Hybrid Recanalization for the Treatment of Carotid/Vertebral In-stent Restenosis or Occlusion: Pilot Surgery Experiences From One Single Center

et al. 2020

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“…118 As placas ateroscleróticas se localizam predominantemente na origem das artérias vertebrais, sendo que na maioria dos casos são extensões de placas das artérias subclávias. 119 A presença de estenose vertebrobasilar na vigência de um AVE ou AIT envolvendo a circulação posterior aumenta em aproximadamente 33% o risco de recorrência no primeiro mês após o evento inicial. 120,121 A descrição detalhada da anatomia das artérias do sistema vertebrobasilar pode ser encontrada na diretriz do DIC 2015 que antecede esta atualização.…”

Section: Introductionunclassified