Carotid artery stenting for patients with occipital-vertebral anastomosis.
Occipital vertebral anastomosis
carotid artery stenting
embolic protection technique
Journal
Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences
ISSN: 2385-2011
Titre abrégé: Interv Neuroradiol
Pays: United States
ID NLM: 9602695
Informations de publication
Date de publication:
Apr 2019
Apr 2019
Historique:
pubmed:
3
10
2018
medline:
6
8
2019
entrez:
2
10
2018
Statut:
ppublish
Résumé
We report the outcomes of carotid artery stenting for patients with angiographically visible occipital artery-vertebral artery anastomosis. Among 47 consecutive patients who underwent carotid artery stenting from January 2007 to December 2010, seven patients for whom cerebral angiograms clearly showed occipital artery-vertebral artery anastomosis were selected. Four different protection methods were used: distal internal carotid artery protection; carotid flow reversal; seatbelt and airbag technique; and double protection method of protecting both the external and internal carotid artery. One patient with distal internal carotid artery protection showed a high-intensity lesion at the border of the upper thalamus, internal capsule and lateral ventricle wall after carotid artery stenting. The other patient with the double protection method did not show any high-intensity lesions on postoperative diffusion-weighted imaging in the vertebrobasilar territory. All seven patients with visible occipital artery-vertebral artery anastomosis showed ipsilateral vertebral artery severe stenosis or occlusion. Large occipital artery-vertebral artery anastomosis may be a pathway for embolic materials during carotid artery stenting. External carotid artery protection is recommended for carotid artery stenting in such patients.
Sections du résumé
BACKGROUND AND PURPOSE
OBJECTIVE
We report the outcomes of carotid artery stenting for patients with angiographically visible occipital artery-vertebral artery anastomosis.
METHODS
METHODS
Among 47 consecutive patients who underwent carotid artery stenting from January 2007 to December 2010, seven patients for whom cerebral angiograms clearly showed occipital artery-vertebral artery anastomosis were selected. Four different protection methods were used: distal internal carotid artery protection; carotid flow reversal; seatbelt and airbag technique; and double protection method of protecting both the external and internal carotid artery.
RESULTS
RESULTS
One patient with distal internal carotid artery protection showed a high-intensity lesion at the border of the upper thalamus, internal capsule and lateral ventricle wall after carotid artery stenting. The other patient with the double protection method did not show any high-intensity lesions on postoperative diffusion-weighted imaging in the vertebrobasilar territory. All seven patients with visible occipital artery-vertebral artery anastomosis showed ipsilateral vertebral artery severe stenosis or occlusion.
CONCLUSION
CONCLUSIONS
Large occipital artery-vertebral artery anastomosis may be a pathway for embolic materials during carotid artery stenting. External carotid artery protection is recommended for carotid artery stenting in such patients.
Identifiants
pubmed: 30269667
doi: 10.1177/1591019918802924
pmc: PMC6448366
doi:
Substances chimiques
Platelet Aggregation Inhibitors
0
Types de publication
Journal Article
Langues
eng
Pagination
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