1
|
Nana P, Spanos K, Kouvelos G, Georgakopoulou VE, Lempesis IG, Trakas N, Sklapani P, Paterakis K, Fotakopoulos G, Brotis AG. Carotid artery stenting and endarterectomy surgery techniques: A 30‑year time‑lapse. MEDICINE INTERNATIONAL 2023; 3:61. [PMID: 38204583 PMCID: PMC10777268 DOI: 10.3892/mi.2023.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 10/30/2023] [Indexed: 01/12/2024]
Abstract
Carotid endarterectomy or carotid artery stenting (CAS), are the most important axes in carotid artery interventional management. A bibliometric analysis permits an easier access to the current literature trends and information to design future studies. The aim of the present study was to identify the knowledge routes on CAS and examine the research front on the topic. The search was interpreted in Scopus, from 1994 to 2023, and included only original articles and reviews. The BibTex format was used to download all citation and bibliographic data. The present analysis was conducted in two parts, a descriptive one and a network extraction process. Between 1994 and 2023, 34,503 references and 7,758 authors were recorded. The annual growth rate was 21.64%. The CAVATAS trial was the most cited article. As regards word trends, since 2017, trans-carotid stenting, risk factors and plaque characteristics are highlighted. CAS remains an area of high interest with a publication growth rate of >20% per year. As numerous questions remain to be answered, the need to determine the role of CAS may drive further research.
Collapse
Affiliation(s)
- Petroula Nana
- Department of Vascular Surgery, Larissa University Hospital, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41221 Larissa, Greece
| | - Konstantinos Spanos
- Department of Vascular Surgery, Larissa University Hospital, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41221 Larissa, Greece
| | - George Kouvelos
- Department of Vascular Surgery, Larissa University Hospital, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41221 Larissa, Greece
| | | | - Ioannis G. Lempesis
- Department of Pathophysiology, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Nikolaos Trakas
- Department of Biochemistry, Sismanogleio Hospital, 15126 Athens, Greece
| | - Pagona Sklapani
- Department of Biochemistry, Sismanogleio Hospital, 15126 Athens, Greece
| | - Konstantinos Paterakis
- Department of Neurosurgery, General University Hospital of Larissa, 41221 Larissa, Greece
| | - George Fotakopoulos
- Department of Neurosurgery, General University Hospital of Larissa, 41221 Larissa, Greece
| | - Alexandros G. Brotis
- Department of Neurosurgery, General University Hospital of Larissa, 41221 Larissa, Greece
| |
Collapse
|
2
|
Abe D, Hanaoka Y, Koyama JI, Nakamura T, Kitamura S, Ogiwara T, Horiuchi T. New Cerebral Embolic Protection System for Endovascular Revascularization of Stenosis at the Origin of the Right Common Carotid Artery: the Counterflow Technique. Clin Neuroradiol 2023; 33:857-864. [PMID: 37171610 DOI: 10.1007/s00062-023-01290-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 03/27/2023] [Indexed: 05/13/2023]
Affiliation(s)
- Daishiro Abe
- Department of Neurosurgery, Shinshu University School of Medicine, 3-1-1 Asahi, 390-8621, Matsumoto, Japan
| | - Yoshiki Hanaoka
- Department of Neurosurgery, Shinshu University School of Medicine, 3-1-1 Asahi, 390-8621, Matsumoto, Japan.
- Neuroendovascular Therapy Center, Shinshu University Hospital, 3-1-1 Asahi, 390-8621, Matsumoto, Japan.
| | - Jun-Ichi Koyama
- Neuroendovascular Therapy Center, Shinshu University Hospital, 3-1-1 Asahi, 390-8621, Matsumoto, Japan
| | - Takuya Nakamura
- Department of Neurosurgery, Shinshu University School of Medicine, 3-1-1 Asahi, 390-8621, Matsumoto, Japan
| | - Satoshi Kitamura
- Neuroendovascular Therapy Center, Shinshu University Hospital, 3-1-1 Asahi, 390-8621, Matsumoto, Japan
| | - Toshihiro Ogiwara
- Department of Neurosurgery, Shinshu University School of Medicine, 3-1-1 Asahi, 390-8621, Matsumoto, Japan
| | - Tetsuyoshi Horiuchi
- Department of Neurosurgery, Shinshu University School of Medicine, 3-1-1 Asahi, 390-8621, Matsumoto, Japan
- Neuroendovascular Therapy Center, Shinshu University Hospital, 3-1-1 Asahi, 390-8621, Matsumoto, Japan
| |
Collapse
|
3
|
George JM, Cooke PV, Ilonzo N, Tadros RO, Grossi RJ. Management of Innominate Artery Occlusion With Severe Left Common Carotid Artery Stenosis. Cureus 2021; 13:e19592. [PMID: 34926061 PMCID: PMC8671066 DOI: 10.7759/cureus.19592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2021] [Indexed: 11/27/2022] Open
Abstract
Innominate artery occlusion is a rare entity, particularly when coupled with severe left common carotid artery stenosis. Innominate artery disease may present with varying degrees of symptomatology and can place patients at risk for both posterior fossa and hemispheric ischemic events. We present a symptomatic case of innominate artery occlusion with severe left common carotid disease. We reviewed the literature and current options for the treatment of innominate artery disease. The patient underwent successful hybrid repair with left carotid artery retrograde stenting and left carotid artery to right carotid artery bypass. She has been symptom and re-intervention free during her one-year follow-up. We describe a successful hybrid repair of symptomatic innominate artery occlusion with concomitant severe left carotid artery stenosis in a patient with a prohibitive open thoracic surgical risk.
Collapse
Affiliation(s)
- Justin M George
- Division of Vascular Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Peter V Cooke
- Division of Vascular Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Nicole Ilonzo
- Division of Vascular and Endovascular Surgery, Department of Surgery, Weill Cornell, New York, USA
| | - Rami O Tadros
- Division of Vascular Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Robert J Grossi
- Division of Vascular Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, USA
| |
Collapse
|
4
|
Tesar J, Favot D, Williams L, Tesar P. Aorto-carotid bypass for orthostatic mediated hypoperfusion transient ischaemic attacks: A case report. Int J Surg Case Rep 2021; 81:105780. [PMID: 33756170 PMCID: PMC8020438 DOI: 10.1016/j.ijscr.2021.105780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 03/13/2021] [Accepted: 03/14/2021] [Indexed: 11/27/2022] Open
Abstract
Orthostatic mediated hypoperfusion transient ischaemic attack is a rare phenomenon. Aorto-carotid bypass is an uncommon procedure usually performed in the setting of dissections and vasculitis affecting the supra-aortic branch vessels. Aorto-carotid bypass can be considered in patients with symptomatic atherosclerotic disease of the supra-aortic branch vessels.
Introduction and importance Aorto-carotid bypass is a rare procedure. It is reported to be performed for management of cerebral malperfusion in the setting of supra-aortic branch vessel disease. Malperfusion requiring a bypass is largely secondary to dissection or vasculitis. Atherosclerotic disease of the supra-aortic branch vessels is commonly managed via an endovascular approach. We report a rare and atypical presentation of cerebral malperfusion in the setting of atherosclerotic disease of the innominate and carotid arteries managed with an aorto-carotid bypass graft. Case presentation A case report of an 80-year-old female presenting with orthostatic mediated hypoperfusion transient ischaemic attacks with episodes of limb shaking and unilateral weakness with postural changes. The malperfusion was in the setting of severe atherosclerotic disease of the innominate and carotid arteries. Clinical discussion and conclusion Our patient was not amendable to endovascular intervention or a less invasive open approach. The patient underwent an aorto-carotid bypass graft with complete resolution of symptoms. This case highlights a rare manifestation of orthostatic mediated cerebral malperfusion and a successful novel treatment method.
Collapse
Affiliation(s)
- Joshua Tesar
- Department of Vascular Surgery, Royal Brisbane and Women's Hospital, Brisbane, Australia.
| | - Danella Favot
- Department of Vascular Surgery, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Livia Williams
- Department of Cardiothoracic Surgery, The Prince Charles Hospital, Brisbane, Australia
| | - Peter Tesar
- Department of Cardiothoracic Surgery, The Prince Charles Hospital, Brisbane, Australia
| |
Collapse
|
5
|
Huang CC, Huang WM, Jhou ZY, Chen JH, Chen ST, Lin HC, Huang CY, Chen CH, Luo CB, Chang FC. Angioplasty and stenting for symptomatic stenosis of the left subclavian artery complicated with aortic dissection. J Chin Med Assoc 2021; 84:273-279. [PMID: 33496512 DOI: 10.1097/jcma.0000000000000492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Aortic dissection is a rare but severe complication of percutaneous transluminal angioplasty and stenting (PTAS) for stenosis of the subclavian artery (SA). This retrospective study was designed to evaluate the risk factors and outcomes of patients with severe stenosis of the SA who underwent PTAS complicated by aortic dissection. METHODS Between 1999 and 2018, 169 cases of severe symptomatic stenosis of the SA underwent PTAS at our institute. Of them, six cases complicated by aortic dissection were included in this study. We evaluated the demographic features, technical factors of PTAS, and clinical outcomes in these six patients. RESULTS Aortic dissection occurred in 5.3% (6/113) of all left SA stenting cases but in none of the right SA stenting cases. All patients had hypertension and a high severity of SA stenosis (85.0 ± 13.0%, 60%-95%). Five of the six patients received balloon-expandable stents (83.3%). All patients had spontaneous resolution of the aortic dissection with conservative treatment. In a 63.33 ± 33.07 (7-118) month follow-up, five of the six patients (83.3%) had long-term symptom relief and stent patency. CONCLUSION Aortic dissection occurred in patients who underwent PTAS for severe stenosis of the left SA, mainly with balloon-expandable stents. We suggest using self-expandable stents and angioplasty with an undersized balloon during PTAS for severe stenosis of the left proximal SA to prevent aortic dissection.
Collapse
Affiliation(s)
- Chun-Chao Huang
- Department of Radiology, MacKay Memorial Hospital, Taipei, Taiwan, ROC
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan, ROC
| | - Wei-Ming Huang
- Department of Radiology, MacKay Memorial Hospital, Taipei, Taiwan, ROC
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan, ROC
- Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan, ROC
| | - Zong-Yi Jhou
- Department of Radiology, MacKay Memorial Hospital, Taipei, Taiwan, ROC
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan, ROC
- Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan, ROC
| | - Jung-Hsuan Chen
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Shu-Ting Chen
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Hui-Chen Lin
- Department of Radiology, Sinying Hospital, Ministry of Health and Welfare, Tainan, Taiwan, ROC
| | - Chung-Yao Huang
- Department of Radiology, MacKay Memorial Hospital, Taipei, Taiwan, ROC
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan, ROC
- Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan, ROC
| | - Chia-Hung Chen
- Department of Radiology, MacKay Memorial Hospital, Taipei, Taiwan, ROC
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan, ROC
- Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan, ROC
| | - Chao-Bao Luo
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Feng-Chi Chang
- Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan, ROC
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| |
Collapse
|
6
|
(Coronaro-subclavial steal syndrome as a rare cause of circulatory arrest). COR ET VASA 2020. [DOI: 10.33678/cor.2020.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
7
|
Chong JH, Harky A, Badran A, Panagiotopoulos N, Odurny A, Philips M, Livesey S, Pousios D. Aorto-innominate artery bypass for migrated stent. J Card Surg 2020; 36:312-314. [PMID: 33032362 DOI: 10.1111/jocs.15092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 08/05/2020] [Accepted: 09/22/2020] [Indexed: 11/28/2022]
Abstract
We report a case of a 64-year-old female who first presented with a transient ischemic attack in 2007 due to an innominate artery stenosis, which indicated an endovascular stent placement. In 2008, she presented with recurrence of symptoms and was diagnosed with in-stent restenosis alongside an unusual occurrence of retrograde migration into the ascending aortic arch. We performed an aorto-innominate bypass through a median sternotomy. The patient was discharged without any complications thereafter, and the graft has shown excellent patency. As of 2019, the patient remains well.
Collapse
Affiliation(s)
- Jun Heng Chong
- GKT School of Medical Education, King's College London, London, UK
| | - Amer Harky
- Department of Cardiothoracic Surgery, Liverpool Heart and Chest Hospital, Liverpool, UK.,Liverpool Center for Cardiovascular Science, Liverpool Heart and Chest Hospital, University of Liverpool, Liverpool, UK
| | - Abdul Badran
- Department Cardiothoracic Surgery, Southampton General Hospital, Southampton, UK
| | | | - Allan Odurny
- Department of Interventional Radiology, Southampton General Hospital, Southampton, UK
| | - Michael Philips
- Department of Vascular Surgery, Southampton General Hospital, Southampton, UK
| | - Steven Livesey
- Department Cardiothoracic Surgery, Southampton General Hospital, Southampton, UK
| | - Dimitrios Pousios
- Department of Cardiothoracic Surgery, Liverpool Heart and Chest Hospital, Liverpool, UK.,Department Cardiothoracic Surgery, Southampton General Hospital, Southampton, UK
| |
Collapse
|
8
|
Wang LJ, Crofts SC, Nixon TP, Goudreau BJ, Chang DC, Conrad MF, Eagleton MJ, Clouse WD. Impact of Adding Carotid Endarterectomy to Supra-aortic Trunk Surgical Reconstruction. Ann Vasc Surg 2020; 69:27-33. [PMID: 32599112 DOI: 10.1016/j.avsg.2020.06.037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/20/2020] [Accepted: 06/20/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Up to 20% of patients requiring open supra-aortic trunk (SAT) reconstruction have significant carotid artery stenosis. The addition of carotid endarterectomy (CEA) to SAT has been described. Yet, additive risks are not well defined and controversy remains as to whether concomitant CEA increases stroke risk. This study assessed the perioperative effects of adding CEA to SAT. METHODS Using the National Surgical Quality Improvement Program (NSQIP), patients who underwent SAT from 2005 to 2015 were evaluated. SAT + CEA were identified. An isolated SAT (ISAT) cohort was created by removing patients who underwent concurrent secondary procedures. Nonocclusive indications were excluded. SAT + CEA were compared with ISAT as well as a propensity-matched ISAT cohort. Primary outcomes were 30-day stroke, death, and composite stroke/death/myocardial infarction (SDM). Univariate and logistic regression analyses were performed. RESULTS After review, 1,515 patients were identified: 1,245 ISAT (82%) and 270 SAT + CEA (18%). Most were women (56%), 86% were Caucasian, and 24% were symptomatic. Average age was 65 ± 12 years and SAT + CEA were older (69 vs. 64 years, P < 0.001). CEA + SAT were more likely to be men (53% vs. 42%, P < 0.001), have hypertension (86% vs. 75%, P < 0.001) and diabetes (26% vs. 20%, P = 0.04). SAT procedures included the following: carotid-subclavian bypass (68%), carotid-carotid bypass (16%), aorta-great vessel bypass (9%), and carotid-subclavian transposition (7%). ISAT were more likely to undergo carotid-subclavian bypass than SAT + CEA (71% vs. 54%, P < 0.001). Overall stroke was 2.3%, death 1.4%, and SDM 4.6%. There were no differences in 30-day stroke (ISAT 2.0% vs. SAT + CEA 3.7%, P = 0.09) or mortality (1.4% vs. 1.5%, P = 0.88). SAT + CEA had higher rates of SDM (7% vs. 4%, P = 0.03). On logistic regression, urgency was a predictor of SDM (operating room [OR] 3.6, 95% confidence interval [CI] 1.5-8.4, P = 0.003); addition of CEA was not predictive of stroke (OR 1.4, 95% CI 0.5-4.2, P = 0.52) or SDM (OR 1.5, 95% CI 0.6-3.6, P = 0.40). After propensity matching, there were no longer differences in demographics or primary end points between the 2 cohorts. CONCLUSIONS Addition of CEA does not confer increased perioperative stroke or SDM risk over ISAT. Perioperative outcomes appear to be more affected by disseminated disease risk factors than the addition of CEA. In patients undergoing SAT, it is reasonable to consider performing combined CEA in populations with tandem carotid bifurcation disease and appropriate operative risk profile.
Collapse
Affiliation(s)
- Linda J Wang
- Division of Vascular and Endovascular Surgery, Massachusetts General Hospital, Boston, MA
| | - Sarah C Crofts
- Division of Vascular and Endovascular Surgery, Massachusetts General Hospital, Boston, MA
| | - Thomas P Nixon
- Division of Vascular and Endovascular Surgery, Massachusetts General Hospital, Boston, MA
| | - Bernadette J Goudreau
- Division of Vascular and Endovascular Surgery, University of Virginia, Charlottesville, VA
| | - David C Chang
- Division of Vascular and Endovascular Surgery, Massachusetts General Hospital, Boston, MA
| | - Mark F Conrad
- Division of Vascular and Endovascular Surgery, Massachusetts General Hospital, Boston, MA
| | - Matthew J Eagleton
- Division of Vascular and Endovascular Surgery, Massachusetts General Hospital, Boston, MA
| | - W Darrin Clouse
- Division of Vascular and Endovascular Surgery, University of Virginia, Charlottesville, VA.
| |
Collapse
|
9
|
Zacharias N, Goodney PP, DeSimone JP, Stone DH, Wanken ZJ, Suckow BD, Columbo JA, Powell RJ. Outcomes of Innominate Artery Revascularization Through Endovascular, Hybrid, or Open Approach. Ann Vasc Surg 2020; 69:190-196. [PMID: 32554196 DOI: 10.1016/j.avsg.2020.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 06/06/2020] [Accepted: 06/09/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Atherosclerotic disease of the innominate artery (IA) is rare and can lead to cerebral, upper extremity, and vertebral steal symptoms. Nonocclusive lesions can be treated with endovascular interventions, often with a hybrid approach while performing a right carotid endarterectomy (RCEA). Calcified IA lesions have a high risk of embolization to bilateral cerebral hemispheres. Occlusive lesions may require treatment through a median sternotomy and bypass. The purpose of our study is to review our short-term and long-term outcomes of IA revascularization. METHODS Our operative database was used to identify patients who underwent IA revascularization between January 1998 and December 2018. Patients who underwent innominate artery stenting (IAS), combined with RCEA and IAS as well as aortoinnominate bypass (AIB), were identified. Our primary end points were freedom from neurologic event, all-cause mortality, and need for reintervention. RESULTS Thirty-three patients (18 females [55%]) who underwent IA revascularization were identified. Average age was 67 ± 8 years, and mean clinical follow-up was 51 ± 21 months. Most patients (30 [91%]) were on a statin and antiplatelet therapy. Twenty-one patients (64%) were symptomatic. Twelve patients (36%) were asymptomatic and underwent combined RCEA with retrograde IAS for critical right carotid stenosis and IA stenosis. Preoperative imaging included a carotid duplex and computed tomography angiography. Eighteen patients (55%) underwent RCEA + IAS, 11 patients (33%) underwent isolated IAS, and 4 patients (12%) underwent AIB. In our attempt to protect bilateral hemispheres during IAS for heavily calcified lesions, we used right common carotid artery (CCA) clamping although open exposure and left CCA embolic protection filter was placed through transfemoral approach. Patients who underwent AIB had chronic heavily calcified IA occlusions or occluded IA stents with failed endovascular interventions. Perioperative stroke rate was 3%, involving 1 patient who developed reperfusion syndrome after RCEA + IAS. Perioperative mortality was 0%. Long-term stroke rate was 0%, and long-term mortality was 15% (5 of 33) because of cardiac disease. Overall restenosis rate was 9%, involving 3 patients who required secondary interventions for IA in-stent restenosis. CONCLUSIONS IA interventions through a hybrid approach or an open approach are safe, with acceptable perioperative stroke and mortality rates. Long-term patency of these interventions is acceptable. Bilateral cerebral embolic protection can be accomplished by clamping the right CCA through an open exposure and placing a filter in the left CCA through a transfemoral approach. Patients undergoing IAS appear to have a higher rate of restenosis compared with AIB, and therefore, close follow-up with noninvasive imaging is recommended.
Collapse
Affiliation(s)
- Nikolaos Zacharias
- Department of Surgery, Section of Vascular Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH.
| | - Philip P Goodney
- Department of Surgery, Section of Vascular Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH
| | - Joseph P DeSimone
- Department of Surgery, Section of Vascular Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH
| | - David H Stone
- Department of Surgery, Section of Vascular Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH
| | - Zachary J Wanken
- Department of Surgery, Section of Vascular Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH
| | - Bjoern D Suckow
- Department of Surgery, Section of Vascular Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH
| | - Jesse A Columbo
- Department of Surgery, Section of Vascular Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH
| | - Richard J Powell
- Department of Surgery, Section of Vascular Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH
| |
Collapse
|
10
|
Endovascular stenting of supra-aortic lesions using a transcarotid retrograde approach and flow reversal: A multicenter case series. J Vasc Surg 2020; 71:2012-2020.e18. [DOI: 10.1016/j.jvs.2019.08.269] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Accepted: 08/20/2019] [Indexed: 01/10/2023]
|
11
|
GÜNEŞLİ A, AKGÜL E. Supraaortik multiple stenozlarda eş zamanlı balon anjiyoplasti ve stent implantasyonu. CUKUROVA MEDICAL JOURNAL 2020. [DOI: 10.17826/cumj.626386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
12
|
Yamao Y, Ishii A, Satow T, Iihara K, Sakai N. The Current Status of Endovascular Treatment for Extracranial Steno-occlusive Diseases in Japan: Analysis Using the Japanese Registry of Neuroendovascular Therapy 3 (JR-NET3). Neurol Med Chir (Tokyo) 2020; 60:1-9. [PMID: 31748443 PMCID: PMC6970071 DOI: 10.2176/nmc.st.2018-0315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Endovascular treatment of extracranial steno-occlusive lesions is an alternative to direct surgery. There is no consensus regarding the natural course and standard treatment of these lesions. The aim of this study was to identify the current status of endovascular treatment for extracranial steno-occlusive lesions. A total of 1154 procedures for extracranial steno-occlusive lesions, except for internal carotid artery stenosis, were collected from the Japanese Registry of Neuroendovascular Therapy 3 (JR-NET3). Atherosclerotic lesions were most frequent (1021 patients, 88.5%). Endovascular treatment was performed for 456 (39.5%) patients with subclavian artery, 349 (30.2%) with extracranial vertebral artery, 172 (14.9%) with the origin of common carotid artery, and 38 (3.3%) with innominate artery stenosis; the overall technical success rate was 98.0%. Percutaneous transluminal angioplasty was performed in 307 patients (26.6%) and stenting in 838 (72.6%). An embolic protection device (EPD) was used in 571 patients (49.5%), and procedure under general anesthesia was performed in 168 (14.6%). Preoperative antiplatelet therapy was administered in 1091 procedures (94.5%). A good outcome was obtained for 962 patients (83.4%). Complications were observed in 89 patients (7.7%). The procedure under general anesthesia was statistically significant factors (P <0.01), and also after multivariable adjustment (odds ratio 2.29; 95% confidence interval 1.25–4.17; P <0.01). Comparisons between JR-NET3 and previous cohorts (JR-NET1&2), the utilization of EPD and complications increased significantly, and the type of antiplatelet therapy changed markedly. Based on the results of this study, endovascular treatment for extracranial steno-occlusive lesions is relatively safe. Further prospective studies are necessary to validate the beneficial effects.
Collapse
Affiliation(s)
- Yukihiro Yamao
- Department of Neurosurgery, Kyoto University Graduate School of Medicine
| | - Akira Ishii
- Department of Neurosurgery, Kyoto University Graduate School of Medicine
| | - Tetsu Satow
- Department of Neurosurgery, National cerebral and Cardiovascular Center
| | - Koji Iihara
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University
| | - Nobuyuki Sakai
- Department of Neuroendovascular Therapy, Institute of Biomedical Research and Innovation.,Department of Neurosurgery, Kobe City Medical Center General Hospital
| | | |
Collapse
|
13
|
Use of a Dual-Filter Embolic Protection Device for Brachiocephalic Artery Stenting. Ann Vasc Surg 2019; 65:282.e13-282.e15. [PMID: 31676379 DOI: 10.1016/j.avsg.2019.10.065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 10/13/2019] [Accepted: 10/14/2019] [Indexed: 11/22/2022]
Abstract
A 77-year-old female with peripheral artery disease underwent brachiocephalic artery stenting for right upper extremity claudication. Given a very high atherosclerotic burden seen on CT, a dual-filter embolic protection device (Sentinel, Boston Scientific) was deployed from the right radial artery to protect the right common carotid and subclavian arteries, and therefore the vertebral artery, during the stenting procedure. This case report demonstrates a novel use of this dual-filter device to provide both carotid and vertebral artery embolic protection during brachiocephalic artery intervention.
Collapse
|
14
|
Krishnappa S, Rachaiah JM, Hegde SS, Sadananda KS, Nanjappa MC, Ramasanjeevaiah G. Percutaneous Antegrade and Retrograde Endovascular approach to Symptomatic High-Grade Subclavian Artery Stenosis: Technique and Follow-Up. Heart Views 2019; 20:87-92. [PMID: 31620253 PMCID: PMC6791090 DOI: 10.4103/heartviews.heartviews_31_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background and Purpose: Angioplasty and stenting of the subclavian artery have been reported with high technical and clinical success rates, low complication rates, and good midterm patency rates. Different antegrade or retrograde endovascular catheter-based approaches are used. Nowadays, endovascular therapy has taken over open surgical techniques in subclavian artery disease. The purpose of this study was to determine safety, efficacy, and midterm clinical and radiological outcome of the endovascular treatment with special focus on the different technical approaches in subclavian artery disease. Materials and Methods: Between 2014 and 2017, 11 patients (10 men, 1 woman) with symptomatic high-grade stenosis (90%–100%) of the subclavian artery were treated with endovascular treatment. Their mean age was 51.3 years (range, 32-61 years). Mean angiographic and clinical follow-up was 22.5 months (range, 5-44 months). Clinical follow-up was performed at hospital discharge and routine follow-up was performed at 1, 3, 12 months, and 6 monthly thereafter. In all 11 patients, a percutaneous approach was used successfully. In eight patients, the lesions were accessed retrogradely through a brachial artery puncture. Results: Acute success rate was 100%. There were no significant peri-procedure complications. At the latest clinical follow-up (mean of 22.5 months), all patients showed a good outcome with a restenosis rate of 18.2% including a patient with Takayasu arteritis. Conclusion: Percutaneous antegrade and retrograde stenting of high-grade subclavian artery stenosis is a viable less invasive alternative to open bypass surgery with good midterm clinical results and patency rates.
Collapse
Affiliation(s)
- Santhosh Krishnappa
- Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Mysore, Karnataka, India
| | | | - Srinidhi S Hegde
- Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Mysore, Karnataka, India
| | | | | | - Govardhan Ramasanjeevaiah
- Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Mysore, Karnataka, India
| |
Collapse
|
15
|
Meershoek AJ, Velde HM, Toorop RJ, Hazenberg SC, de Borst GJ. Long-Term Outcome of Symptomatic Patients Undergoing Hybrid Revascularisation for Extracranial Carotid Artery Tandem Stenosis. Eur J Vasc Endovasc Surg 2019; 57:627-631. [DOI: 10.1016/j.ejvs.2018.11.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 11/22/2018] [Indexed: 11/26/2022]
|
16
|
Ammi M, Henni S, Salomon Du Mont L, Settembre N, Loubiere H, Sobocinski J, Gouëffic Y, Feugier P, Duprey A, Martinez R, Bartoli M, Coscas R, Chaufour X, Kaladji A, Rosset E, Abraham P, Picquet J. Lower Rate of Restenosis and Reinterventions With Covered vs Bare Metal Stents Following Innominate Artery Stenting. J Endovasc Ther 2019; 26:385-390. [DOI: 10.1177/1526602819838867] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Purpose: To determine any difference between bare metal stents (BMS) and balloon-expandable covered stents in the treatment of innominate artery atheromatous lesions. Materials and Methods: A multicenter retrospective study involving 13 university hospitals in France collected 93 patients (mean age 63.2±11.1 years; 57 men) treated over a 10-year period. All patients had systolic blood pressure asymmetry >15 mm Hg and were either asymptomatic (39, 42%) or had carotid (20, 22%), vertebrobasilar (24, 26%), and/or brachial (20, 22%) symptoms. Innominate artery stenosis ranged from 50% to 70% in 4 (4%) symptomatic cases and between 70% and 90% in 52 (56%) cases; 28 (30%) lesions were preocclusive and 8 (9%) were occluded. One (1%) severely symptomatic patient had a <50% stenosis. Demographic characteristics, operative indications, and procedure details were compared between the covered (36, 39%) and BMS (57, 61%) groups. Multivariate analysis was performed to determine relative risks of restenosis and reinterventions [reported with 95% confidence intervals (CI)]. Results: The endovascular procedures were performed mainly via retrograde carotid access (75, 81%). Perioperative strokes occurred in 4 (4.3%) patients. During the mean 34.5±31.2–month follow-up, 30 (32%) restenoses were detected and 13 (20%) reinterventions were performed. Relative risks were 6.9 (95% CI 2.2 to 22.2, p=0.001) for restenosis and 14.6 (95% CI 1.8 to 120.8, p=0.004) for reinterventions between BMS and covered stents. The severity of the treated lesions had no influence on the results. Conclusion: Patients treated with BMS for innominate artery stenosis have more frequent restenoses and reinterventions than patients treated with covered stents.
Collapse
Affiliation(s)
- Myriam Ammi
- Service de Chirurgie Vasculaire, CHU Angers, France
| | - Samir Henni
- Service de Médecine Vasculaire, CHU Angers, France
| | | | | | | | | | | | | | | | | | - Michel Bartoli
- Service de Chirurgie Vasculaire, Assistance Publique–Hôpitaux de Marseille, France
| | - Raphael Coscas
- Service de Chirurgie Vasculaire, Hôpital Ambroise Paré, Paris, France
| | | | | | - Eugenio Rosset
- Service de Chirurgie Vasculaire, CHU Clermont Ferrand, France
| | | | - Jean Picquet
- Service de Chirurgie Vasculaire, CHU Angers, France
| |
Collapse
|
17
|
Zhang X, Ma H, Li L, Zou J, Jiao Y, Zhang X, Yang H. A Meta-Analysis of Transfemoral Endovascular Treatment of Common Carotid Artery Lesions. World Neurosurg 2019; 123:89-94. [DOI: 10.1016/j.wneu.2018.10.072] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 10/08/2018] [Accepted: 10/09/2018] [Indexed: 10/27/2022]
|
18
|
Mansukhani NA, Miller KR, Havelka GE, Russell HM, Eskandari MK. Aorta-innominate bypass through ministernotomy. J Vasc Surg 2018; 68:607-610. [DOI: 10.1016/j.jvs.2018.01.069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 01/16/2018] [Indexed: 10/28/2022]
|
19
|
Illuminati G, Pizzardi G, Pasqua R, Frezzotti F, Palumbo P, Macrina F, Calio' F. Hybrid treatment of tandem, common carotid/innominate artery and ipsilateral carotid bifurcation stenoses by simultaneous, retrograde proximal stenting and eversion carotid endarterectomy: Preliminary results of a case series. Int J Surg 2018. [DOI: 10.1016/j.ijsu.2018.02.062] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
20
|
Results of subclavian to carotid artery bypass for occlusive disease of the common carotid artery: A retrospective cohort study. Int J Surg 2018; 53:111-116. [PMID: 29581047 DOI: 10.1016/j.ijsu.2018.03.038] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 03/19/2018] [Indexed: 11/20/2022]
Abstract
BACKGROUND Optimal treatment of significant atherosclerosis of the common carotid artery (CCA) is not well-defined. The purpose of this study was to evaluate the long-term results of prosthetic subclavian to carotid bypass for occlusive disease of the CCA. MATERIAL AND METHODS From January 1994 to December 2015, 45 patients, mean age 67 years, underwent an ipsilateral subclavian to carotid bypass for occlusive disease of the CCA. Thirty-eight patients (84%) presented with neurologic symptoms, including transitory ischemic attacks in 29 cases and minor strokes in 9 cases. The graft material consisted of a 7 mm polytetrafluoroethylene conduit, and the distal anastomosis was done on the carotid bulb in 21 patients, on the internal carotid artery in 19 cases, and on the distal CCA in 5 cases. Median length of follow-up was 58 months. Study endpoints were the combined postoperative stroke/mortality rate, graft infection, overall late survival, freedom from ipsilateral stroke, and graft patency. RESULTS Postoperative stroke/mortality rate was 2%. No graft infection was observed throughout follow-up. At 60 months, overall survival, freedom from stroke, and graft patency were 71% (standard error [SE] = 0.07), 98% (SE = 0.02), and 95.5% (SE = 0.06), respectively. CONCLUSIONS Subclavian to carotid bypass allows very good patency rates and excellent protection from postoperative and late stroke, remaining a benchmark for any other treatment method.
Collapse
|
21
|
Akif Cakar M, Tatli E, Tokatli A, Kilic H, Gunduz H, Akdemir R. Percutaneous endovascular therapy for symptomatic chronic total occlusion of the left subclavian artery. Singapore Med J 2018; 59:534-538. [PMID: 29546434 DOI: 10.11622/smedj.2018023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Percutaneous endovascular therapy is an accepted and preferred procedure for symptomatic subclavian artery disease. However, the technical feasibility and effectiveness of treating chronic total occlusion of the subclavian artery with this approach is uncertain. We aimed to evaluate the initial and mid-term results of endovascular therapy for patients with symptomatic chronic total occlusion of the left subclavian artery. METHODS Consecutive patients who underwent balloon angioplasty and stenting for chronic total occlusion of the left subclavian artery between January 2010 and February 2014 were included. RESULTS Overall, 16 patients (10 male, 6 female; mean age 56 ± 13 years) underwent balloon angioplasty and stenting for chronic total occlusion of the left subclavian artery. 6 (37.5%) had arm claudication, 8 (50.0%) had vertebrobasilar insufficiency and 2 (12.5%) had coronary steal. 18 balloon-expandable stents were implanted in 15 patients. Central luminal passage was not achieved in one patient because of the subintimal position of the guidewire (procedural success rate 93.8%). There were no procedure-related complications. Mean preprocedural and postprocedural systolic blood pressure differences between the upper extremities were 37 ± 13 (range 25-60) mmHg and 11 ± 9 (range 5-38) mmHg, respectively; the improvement was statistically significant. Outpatient follow-up revealed one asymptomatic restenosis at two years. The patency rate at two years was 93.3%. CONCLUSION Balloon angioplasty and stenting for chronic total occlusion of the left subclavian artery is safe and effective, with good acute success rate and mid-term patency. Prospective randomised studies on larger patient populations would provide more precise results.
Collapse
Affiliation(s)
- Mehmet Akif Cakar
- Department of Cardiology, Sakarya University School of Medicine, Sakarya, Turkey
| | - Ersan Tatli
- Department of Cardiology, Sakarya University School of Medicine, Sakarya, Turkey
| | - Alptug Tokatli
- Department of Cardiology, Golcuk Military Hospital, Kocaeli, Turkey
| | - Harun Kilic
- Department of Cardiology, Sakarya University School of Medicine, Sakarya, Turkey
| | - Huseyin Gunduz
- Department of Cardiology, Sakarya University School of Medicine, Sakarya, Turkey
| | - Ramazan Akdemir
- Department of Cardiology, Sakarya University School of Medicine, Sakarya, Turkey
| |
Collapse
|
22
|
Radak D, Tanaskovic S, Sagic D, Antonic Z, Gajin P, Babic S, Neskovic M, Matic P, Kovacevic V, Nenezic D, Ilijevski N. A Novel Antegrade Approach for Simultaneous Carotid Endarterectomy and Angioplasty of Proximal Lesions in Patients with Tandem Stenosis of Supraaortic Arch Vessels. Ann Vasc Surg 2017; 44:368-374. [DOI: 10.1016/j.avsg.2017.05.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 05/01/2017] [Accepted: 05/07/2017] [Indexed: 11/26/2022]
|
23
|
Transcarotid Approach for Retrograde Stenting of Proximal Innominate and Common Carotid Artery Stenosis. Ann Vasc Surg 2017; 43:242-248. [DOI: 10.1016/j.avsg.2017.02.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2016] [Revised: 01/03/2017] [Accepted: 02/14/2017] [Indexed: 11/22/2022]
|
24
|
Synchronous Carotid Bifurcation Endarterectomy and Retrograde Kissing Stenting of the Innominate and Left Common Carotid Artery in a Patient with a Bovine Aortic Arch. Case Rep Surg 2017; 2017:4239829. [PMID: 28487806 PMCID: PMC5405376 DOI: 10.1155/2017/4239829] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2017] [Accepted: 04/02/2017] [Indexed: 11/18/2022] Open
Abstract
Management of the symptomatic multiple stenosis of supra-aortic vessels (MSSVs) in a “bovine” aortic arch (BAA) configuration is infrequently reported. The optimal treatment choice remains debatable. A successful hybrid treatment for a proximal critical stenosis of the innominate and left common carotid artery was performed in a high-risk patient with a tandem symptomatic lesion in the right carotid bifurcation and a concentric vulnerable plaque in the bovine trunk. This case supports the feasibility, safety, and efficacy of a combined carotid bifurcation endarterectomy and retrograde kissing stenting of common carotid arteries with cerebral protection after evaluation of radiological, anatomical, and clinical parameters.
Collapse
|
25
|
Lazovski N, Jovev S, Babic D, Babic S, Dzemali O. Transposition of Subclavian Artery - Is It the Appropriate Choice? Pril (Makedon Akad Nauk Umet Odd Med Nauki) 2017; 38:47-51. [PMID: 28593884 DOI: 10.1515/prilozi-2017-0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION To present patients with symptomatic subclavian artery disease and treatment possibility. CASE REPORT A 53-year-old female was admitted with vertigo and left arm claudication. Duplex-scan and MSCT arteriography verified subclavian artery occlusion. After the endovascular treatment failure, the patient was switched to surgical treatment - subclavian artery transposition. After the successful surgical treatment, the patient was discharged on the second postoperative day. If the patient is a candidate for surgery, the literature review shows good initial and long-term results after the subclavian artery transposition, and emphasizes this technique as superior. CONCLUSION Subclavian carotid transposition is a safe and effective method of treatment in patients after endovascular treatment failure or other indication. Also, the surgical treatment is technically demanding because of the difficult access to the vessel origin, and it requires experienced surgeons.
Collapse
Affiliation(s)
| | - Sasko Jovev
- University Clinic for Cardiac Surgery, Skopje
| | - Dusan Babic
- Institute for Cardiovascular diseases, Dedinje, Belgrade
| | - Srdjan Babic
- Institute for Cardiovascular diseases, Dedinje, Belgrade
| | | |
Collapse
|
26
|
Bates MC, Aburahma AF. History and Current Status of Endovascular Management for the Extracranial Carotid and Supra-Aortic Vessels. J Endovasc Ther 2016; 11 Suppl 2:II107-127. [PMID: 15760252 DOI: 10.1177/15266028040110s608] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Few procedures in the history of medicine have been more controversial than carotid artery stenting (CAS) for the management of carotid artery occlusive disease. Introduced just as the randomized trials were establishing carotid endarterectomy as the gold standard for carotid interventions, CAS has finally reached the point in its development when dedicated stenting systems are being tested in randomized clinical trials. Assisted by the concomitant use of distal protection devices, CAS has shown equipoise with endarterectomy in terms of safety at 30 days. This review summarizes the completed and ongoing CAS trials and the applications of endovascular techniques in the supra-aortic vessels.
Collapse
Affiliation(s)
- Mark C Bates
- Vascular Center of Excellence, and the Department of Surgery, Robert C. Byrd Health Sciences Center of West Virginia University, Charleston, West Virginia 25304, USA
| | | |
Collapse
|
27
|
Tsuji K, Fukawa N, Nakagawa N, Watanabe A, Murakami S, Nagatsuka K, Nakano N, Kataoka K, Kato A. Transfemoral Stenting of Stenoses at the Common Carotid Artery Origin Using an Anchoring Technique With a Balloon Protection Device. Neurosurgery 2016; 79:598-603. [PMID: 27309345 DOI: 10.1227/neu.0000000000001312] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Kiyoshi Tsuji
- *Department of Neurosurgery, Kinki University School of Medicine, Osaka, Japan; ‡Department of Neurosurgery, Nara Hospital, Kinki University School of Medicine, Nara, Japan
| | | | | | | | | | | | | | | | | |
Collapse
|
28
|
Kedev S, Zafirovska B, Petkoska D, Vasilev I, Bertrand OF. Results of Transradial Subclavian Artery Percutaneous Interventions After Bilateral or Single Access. Am J Cardiol 2016; 118:918-923. [PMID: 27471055 DOI: 10.1016/j.amjcard.2016.06.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 06/14/2016] [Accepted: 06/14/2016] [Indexed: 12/29/2022]
Abstract
Percutaneous treatment of subclavian artery stenosis or occlusion has become more popular compared with surgical correction. We compared the early and late results of subclavian artery stenting with bilateral or single transradial access. From 2010 to 2015, we recruited 54 consecutive patients. In 35 cases, we used bilateral access, and in 19 cases, ipsilateral single access was used. Left subclavian artery was the culprit vessel in 72% of cases. There were more chronic total occlusions in the bilateral group (77% vs 21%, p = 0.0001). Transradial-only approach was used in all cases, except in 2 cases in the bilateral group where crossover to femoral access was required. Stents were implanted in 94% in bilateral group and 84% in single group (p = 0.47). Procedure duration (40 [35 to 60] vs 20 [15 to 30] minutes), contrast volume (200 [200 to 350] vs 150 [100 to 200] ml and fluoroscopy time (20 [12 to 30] vs 8 [4 to 11] minutes) were higher in bilateral group (all p values <0.0001). Procedural success was 96%. Overall, we observed three <5-cm hematomas and 3 asymptomatic radial artery occlusions at hospital discharge. After successful procedure, blood pressure equalized in 94% in bilateral group and 100% in single group (p = 0.54). Major cardiovascular and cerebrovascular event-free survival up to 5 years was 97% in bilateral group compared with 84% in single group (p = 0.12). Subclavian artery patency at late follow-up was 91% in bilateral group and 95% in single group (p = 1.00). Using single or bilateral transradial approach, subclavian artery lesions or occlusions can be effectively and safely treated without the risks of femoral or brachial access.
Collapse
|
29
|
Tang X, Long WA, Hu C, Tang F, Wang Q, Li L. The modified ‘no touch’ technique in the antegrade endovascular approach for left common carotid artery ostial stenosis stenting. J Neurointerv Surg 2016; 9:137-141. [DOI: 10.1136/neurintsurg-2016-012544] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 07/20/2016] [Accepted: 07/29/2016] [Indexed: 11/04/2022]
Abstract
BackgroundOpen surgery and the retrograde endovascular approach via the distal left common carotid artery (LCCA) have some limitations in LCCA ostial stenosis treatment. The ‘no touch’ technique used in the renal artery was modified for this situation.MethodsFifteen selective LCCA stenosis patients were treated by the modified ‘no touch’ technique in the antegrade endovascular approach from March 2013 to March 2016. Thirteen underwent the transfemoral approach and the other two had the transbrachial approach due to a ‘bovine aortic arch’. Distal embolic protection devices were used in all cases. Follow-up included a neurological examination, carotid duplex scan, and office interview. Mean follow-up time was 18.2±11.5 months.ResultsThe initial technical success rate was 100%. The average procedure time was 84.0±16.3 min. There were no procedure-related deaths. No clinical neurological complications occurred during the in-hospital stay. No incidence of death or major stroke occurred during the follow-up period; 6.7% (1/15) of patients had a contralateral minor stroke, 66.7% (4/6) of symptomatic patients were relieved of initial symptoms, and the rest showed improvement. No patient developed new ipsilateral neurological symptoms and no in-stent restenosis occurred during the follow-up period. These results were confirmed by ultrasound.ConclusionsThe modified ‘no touch’ antegrade endovascular technique is a feasible method for treating LCCA ostial lesions with a satisfactory initial success rate, acceptable procedure time, and comparable mid- and long-term results. This technique could be considered as a complementary option for LCCA ostial stenosis in addition to open surgery and the retrograde endovascular approach.
Collapse
|
30
|
Criado FJ, Abul-Khoudoud O. Interventional Techniques to Facilitate Supraaortic Angioplasty and Stenting. Vasc Endovascular Surg 2016; 40:141-7. [PMID: 16598363 DOI: 10.1177/153857440604000209] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Arterial occlusive disease involving the supra-aortic trunks (SATs) is relatively frequent. Its mere presence does not dictate the need for intervention. Revascularization options include intra and extrathoracic surgical bypasses and transpositions, and percutaneous endovascular approaches with angioplasty and stenting. This paper focuses on a description of the fundamental endovascular techniques and equipment that have proved useful in the senior author's (FJC) 15-year experience with catheter-based intervention for treatment of SAT disease. These procedures have gained in popularity over the years and become the preferred modality for management of most patients today.
Collapse
Affiliation(s)
- Frank J Criado
- Division of Vascular Surgery and Center for Vascular Intervention, Union Memorial Hospital-MedStar Health, Baltimore, MD, USA.
| | | |
Collapse
|
31
|
Liu Y, Zhang J, Gu Y, Guo L, Li J. Clinical Effectiveness of Endovascular Therapy for Total Occlusion of the Subclavian Arteries: A Study of 67 Patients. Ann Vasc Surg 2016; 35:189-96. [DOI: 10.1016/j.avsg.2016.01.051] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 11/02/2015] [Accepted: 01/24/2016] [Indexed: 11/25/2022]
|
32
|
Retrograde stenting of proximal lesions with carotid endarterectomy increases risk. J Vasc Surg 2016; 63:1517-23. [DOI: 10.1016/j.jvs.2016.01.028] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 01/13/2016] [Indexed: 11/23/2022]
|
33
|
Ben Ahmed S, Benezit M, Hazart J, Brouat A, Daniel G, Rosset E. Outcomes of the Endovascular Treatment for the Supra-Aortic Trunks Occlusive Disease: A 14-Year Monocentric Experience. Ann Vasc Surg 2016; 33:55-66. [DOI: 10.1016/j.avsg.2016.02.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 02/14/2016] [Accepted: 02/27/2016] [Indexed: 11/15/2022]
|
34
|
Che WQ, Dong H, Jiang XJ, Peng M, Zou YB, Qian HY, Zhang HM, Wu HY, Yang YJ, Gao RL. Stenting for left subclavian artery stenosis in patients scheduled for left internal mammary artery-coronary artery bypass grafting. Catheter Cardiovasc Interv 2016; 87 Suppl 1:579-88. [PMID: 26914391 DOI: 10.1002/ccd.26477] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2015] [Revised: 01/22/2016] [Accepted: 01/29/2016] [Indexed: 11/11/2022]
Affiliation(s)
- Wu-qiang Che
- Department of Cardiology; Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hui Dong
- Department of Cardiology; Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiong-jing Jiang
- Department of Cardiology; Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Meng Peng
- Department of Cardiology; Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yu-bao Zou
- Department of Cardiology; Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hai-yan Qian
- Department of Cardiology; Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hui-min Zhang
- Department of Cardiology; Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hai-ying Wu
- Department of Cardiology; Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yue-jin Yang
- Department of Cardiology; Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Run-lin Gao
- Department of Cardiology; Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| |
Collapse
|
35
|
Haraguchi T, Urasawa K, Nakama T, Nakagawa Y, Tan M, Koshida R, Sato K. Sheath rendezvous method: a novel distal protection technique during endovascular treatment of subclavian artery occlusions. Cardiovasc Interv Ther 2015. [PMID: 26224140 DOI: 10.1007/s12928-015-0348-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
To describe an innovative distal protection technique, "sheath rendezvous method", during endovascular treatment for subclavian arterial occlusions. 4.5F and 6F guiding sheath were inserted from left brachial and common femoral artery, respectively. 0.014″ guidewire retrogradely passed through occlusion and into antegrade sheath to establish a pull-through system. 3.0 mm balloon was used to expand occlusion and anchor to deliver retrograde sheath into antegrade one. Both sheaths locked by balloon dilatation crossed occlusion until antegrade sheath passed over lesion. Balloon expandable stent was delivered within antegrade sheath. Sheath was removed, and stent was implanted. We obtained an excellent outcome without complications.
Collapse
Affiliation(s)
- Takuya Haraguchi
- Cardiovascular Center, Tokeidai Memorial Hospital, 2-3, Higashi 1, Kita 1, Chuo-ku, Sapporo, Hokkaido, 060-0031, Japan.
| | - Kazushi Urasawa
- Cardiovascular Center, Tokeidai Memorial Hospital, 2-3, Higashi 1, Kita 1, Chuo-ku, Sapporo, Hokkaido, 060-0031, Japan
| | - Tatsuya Nakama
- Department of Cardiology, Miyazaki Medical Association Hospital, Miyazaki, Japan
| | - Yuya Nakagawa
- Cardiovascular Center, Tokeidai Memorial Hospital, 2-3, Higashi 1, Kita 1, Chuo-ku, Sapporo, Hokkaido, 060-0031, Japan
| | - Michinao Tan
- Cardiovascular Center, Tokeidai Memorial Hospital, 2-3, Higashi 1, Kita 1, Chuo-ku, Sapporo, Hokkaido, 060-0031, Japan
| | - Ryoji Koshida
- Cardiovascular Center, Tokeidai Memorial Hospital, 2-3, Higashi 1, Kita 1, Chuo-ku, Sapporo, Hokkaido, 060-0031, Japan
| | - Katsuhiko Sato
- Cardiovascular Center, Tokeidai Memorial Hospital, 2-3, Higashi 1, Kita 1, Chuo-ku, Sapporo, Hokkaido, 060-0031, Japan
| |
Collapse
|
36
|
van de Weijer M, Vonken E, de Vries JP, Moll F, Vos J, de Borst G. Technical and Clinical Success and Long-Term Durability of Endovascular Treatment for Atherosclerotic Aortic Arch Branch Origin Obstruction: Evaluation of 144 Procedures. Eur J Vasc Endovasc Surg 2015; 50:13-20. [DOI: 10.1016/j.ejvs.2015.03.058] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2014] [Accepted: 03/27/2015] [Indexed: 11/16/2022]
|
37
|
Mousa AY, AbuRahma AF, Bozzay J, Broce M, Barsoum E, Bates M. Anatomic and clinical predictors of reintervention after subclavian artery stenting. J Vasc Surg 2015; 62:106-14. [DOI: 10.1016/j.jvs.2015.01.055] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 01/23/2015] [Indexed: 10/23/2022]
|
38
|
Soga Y, Tomoi Y, Fujihara M, Okazaki S, Yamauchi Y, Shintani Y, Suzuki K. Perioperative and Long-term Outcomes of Endovascular Treatment for Subclavian Artery Disease From a Large Multicenter Registry. J Endovasc Ther 2015; 22:626-33. [DOI: 10.1177/1526602815590579] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose: To investigate the perioperative and long-term outcomes of endovascular therapy (EVT) for subclavian artery disease in a large-scale multicenter study. Methods: The study analyzed the outcomes from a multicenter retrospective registry (SubClavian Artery disease treated with endovascuLar therapy; muLticenter retrOsPective registry: SCALLOP) of 718 consecutive patients with upper extremity artery disease who underwent EVT between January 2003 and December 2012 at 37 Japanese cardiovascular centers. Of the 718 patients enrolled in the registry, 162 patients were excluded, leaving 553 patients (mean 70±7 years, range 41–91; 405 men) who underwent primary EVT for de novo subclavian artery disease (560 arms). Results: Procedure success was achieved in 96.8% (100% for stenoses, 91% for total occlusions). The perioperative complication rate was 9.2%. Stroke was found in 1.8%, with ipsilateral posterior infarction accounting for 0.9%. The 30-day mortality was 0.7%. The mean follow-up was 39±24 months. Primary patency estimates were 90.6%±1.3%, 83.4%±1.8%, and 80.5%±2.2% at 1, 3, and 5 years, respectively. There was no significant difference in primary patency between stenotic and occlusive lesions. Secondary patency estimates were 99.2%±0.4%, 98.2%±0.6%, and 97.7%±0.8% at 1, 3, and 5 years, respectively. The respective overall survival rates were 94.6%±1.0%, 86.8%±1.7%, and 79.0%±2.4%. There were 86 deaths during follow-up, of which half were due to cardiovascular causes. On multivariate analysis, critical hand ischemia (hazard ratio [HR] 4.6, 95% CI 2.06 to 10.2, p<0.001), cerebrovascular disease (HR 1.9, 95% CI 1.14 to 3.06, p=0.01), current smoking (HR 1.8, 95% 1.14 to 2.79, p=0.01), and lesion length (in 1-cm increments; HR 1.02, 95% CI 1.00 to 1.04, p=0.03) were negative independent predictors of primary patency, while IVUS use (HR 0.6, 95% CI 0.30 to 0.96, p=0.04) was a positive predictor of primary patency. Conclusion: Primary angioplasty/stenting for subclavian artery disease afforded acceptable outcomes in terms of perioperative complications and long-term patency.
Collapse
Affiliation(s)
- Yoshimitsu Soga
- Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan
| | - Yusuke Tomoi
- Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan
| | - Masahiko Fujihara
- Department of Cardiology, Kishiwada Tokushukai Hospital, Kishiwada, Japan
| | - Shinya Okazaki
- Department of Cardiology, Juntendo University Hospital, Tokyo, Japan
| | | | | | - Kenji Suzuki
- Department of Cardiology, Sendai Kosei Hospital, Sendai, Japan
| | | |
Collapse
|
39
|
Samaniego EA, Katzen BT, Kreusch AS, Uthoff H. Endovascular Treatment of Proximal Aortic Arch Lesions through a Retrograde Approach. INTERVENTIONAL NEUROLOGY 2015; 3:41-7. [PMID: 25999991 DOI: 10.1159/000369302] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Tandem atherosclerotic lesions of the carotid bifurcation and the ipsilateral proximal common carotid artery (CCA) or innominate arteries (IA) can be challenging to treat. A surgical approach may treat the lesion at the carotid bifurcation, but proximal CCA or IA lesions require a major surgical exposure. An endovascular approach is challenging as well since anatomic variations, such as a type III aortic arch, can render navigation very difficult. We report our experience in the hybrid surgical and endovascular treatment of complex proximal CCA and IA lesions. Eleven patients who underwent hybrid procedures with surgical exposure (with or without endarterectomy) of the carotid artery and retrograde endovascular intervention of a proximal lesion were included in the study. The mean percentage of stenosis was 81%. Seven patients underwent a carotid endarterectomy (CEA), and 4 patients underwent only a surgical cutdown for retrograde endovascular access of the IA or left CCA. All procedures were technically successful. Eight patients had no symptoms within 30 days of the procedure. The hybrid retrograde endovascular approach through carotid exposure with or without CEA appears to be effective and safe in selected patients who have a high-risk complex anatomy of tandem lesions.
Collapse
Affiliation(s)
- Edgar A Samaniego
- Departamento de Cirugía Neuroendovascular, Hospital Eugenio Espejo, Quito, Ecuador, Fla., USA
| | - Barry T Katzen
- Division of Vascular and Interventional Radiology, Baptist Cardiac and Vascular Institute, Miami, Fla., USA
| | - Andreas S Kreusch
- Department of Radiology, Cantonal Hospital Winterthur, Winterthur, Switzerland
| | - Heiko Uthoff
- Department of Angiology, University Hospital Basel, Basel, Switzerland
| |
Collapse
|
40
|
Duran M, Grotemeyer D, Danch MA, Grabitz K, Schelzig H, Sagban TA. Subclavian Carotid Transposition: Immediate and Long-Term Outcomes of 126 Surgical Reconstructions. Ann Vasc Surg 2015; 29:397-403. [DOI: 10.1016/j.avsg.2014.09.030] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Revised: 09/17/2014] [Accepted: 09/23/2014] [Indexed: 10/24/2022]
|
41
|
Management of atherosclerotic supraaortic lesions. Eur Surg 2014. [DOI: 10.1007/s10353-014-0268-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
42
|
Martinez R, Kassegne T, Lhommet P, Mirza A, May MA, Maurel B, Marchand E, Enon B. Carotid artery stenting using a transapical approach for the treatment of radiation-induced carotid stenosis. Ann Vasc Surg 2014; 28:1796.e5-7. [PMID: 24911804 DOI: 10.1016/j.avsg.2014.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2014] [Revised: 03/25/2014] [Accepted: 04/11/2014] [Indexed: 10/25/2022]
Abstract
Radiation-induced stenosis of the carotid artery is considered a challenging entity for direct revascularization. We performed a carotid artery stenting for a radiation-induced stenosis using a transapical approach on an asymptomatic 63-year-old male patient. Transapical approach, which is often used for cardiac surgery, was not yet described for the endovascular treatment of carotid stenosis. The transapical approach could be an attractive alternative path for patients presenting significant supra-aortic trunks lesions and unfit for direct approach or peripheral access. This case reports the feasibility and the safety of carotid artery stenting using the transapical approach in well-trained teams.
Collapse
Affiliation(s)
- Robert Martinez
- Department of Thoracic and Cardiovascular Surgery, University Hospital of Tours, Tours, France.
| | - Tchala Kassegne
- Department of Vascular Surgery, University Hospital of Angers, Angers, France
| | - Pierre Lhommet
- Department of Thoracic and Cardiovascular Surgery, University Hospital of Tours, Tours, France
| | - Alain Mirza
- Department of Thoracic and Cardiovascular Surgery, University Hospital of Tours, Tours, France
| | - Marc Antoine May
- Department of Anesthesiology, University Hospital of Tours, Tours, France
| | - Blandine Maurel
- Department of Thoracic and Cardiovascular Surgery, University Hospital of Tours, Tours, France
| | - Etienne Marchand
- Department of Thoracic and Cardiovascular Surgery, University Hospital of Tours, Tours, France
| | - Bernard Enon
- Department of Vascular Surgery, University Hospital of Angers, Angers, France
| |
Collapse
|
43
|
Hashim PW, Assi R, Grecu L, Dardik A. Symptomatic Obstruction of the Brachiocephalic and Left Subclavian Arteries Obscured by Aortic Stenosis. Ann Vasc Surg 2014; 28:737.e1-5. [DOI: 10.1016/j.avsg.2013.04.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Revised: 03/29/2013] [Accepted: 04/09/2013] [Indexed: 12/14/2022]
|
44
|
Stone PA, Srivastiva M, Campbell JE, Mousa AY. Diagnosis and treatment of subclavian artery occlusive disease. Expert Rev Cardiovasc Ther 2014; 8:1275-82. [DOI: 10.1586/erc.10.111] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
45
|
Subclavian revascularization in the age of thoracic endovascular aortic repair and comparison of outcomes in patients with occlusive disease. J Vasc Surg 2013; 58:901-9. [PMID: 23711694 DOI: 10.1016/j.jvs.2013.04.005] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Revised: 04/04/2013] [Accepted: 04/04/2013] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Open surgical revascularization for subclavian artery occlusive disease (OD) has largely been supplanted by endovascular treatment despite the excellent long-term patency of bypass. The indications for carotid-subclavian bypass (C-SBP) and subclavian transposition (ST) have been recently expanded with the widespread application of thoracic endovascular aortic repair (TEVAR), primarily to augment proximal landing zones or treat endovascular failures. This study was performed to determine the outcomes of patients undergoing C-SBP/ST in the context of contemporary endovascular therapies and evolving indications. METHODS A prospective database including all procedures performed at a single institution from 2002 to 2012 was retrospectively queried for patients who underwent subclavian revascularization for TEVAR or OD indications. Patient demographics and perioperative outcomes were recorded. Patency was determined by computed tomography angiography in the TEVAR group. Noninvasive studies were used for the OD patients. Life-table methods were used to estimate patency, reintervention, and survival. RESULTS Of 139 procedures identified, 101 were performed for TEVAR and 38 for OD. All TEVAR patients underwent C-SBP/ST to augment landing zones (49% preoperative; 41% intraoperative), treat arm ischemia (8% postoperative), or for internal mammary artery salvage (2%). OD patients had a variety of indications, including failed stent/arm fatigue, 49%; asymptomatic >80% internal carotid stenosis with concurrent subclavian occlusion, 18%; symptomatic cerebrovascular OD, 13%; redo bypass, 8%; and coronary-subclavian steal, 5%. Differences in postoperative stroke and death, primary patency, or freedom from reintervention were not significant. The 30-day postoperative stroke, death, and combined stroke/death rates were, respectively, 10.8%, 5.8%, and 13.7% for the entire cohort; 8.9%, 7.1%, and 12.9% in TEVAR patients; and 15.8%, 2.6%, and 15.8% in OD patients. The 1- and 3-year primary patencies were, respectively, 94% and 94% for TEVAR and 93% and 73% for OD patients. Survival was similar between the groups, with an estimated survival rate of 88% at 1 year and 76% at 5 years. CONCLUSIONS Stroke risk in this contemporary series of C-SBP/ST performed for TEVAR and OD indications may be higher than previously reported in historical series. In TEVAR patients, this may be attributed to procedural complexity of the TEVAR in patients requiring subclavian revascularization. In OD patients, this is likely due to the changing patient population that requires more frequent concomitant carotid interventions. Despite the short-term morbidity, excellent bypass durability and equivalent long-term patient survival can be anticipated.
Collapse
|
46
|
Al-Natour M, Renno A, El-Fedaly M, Abbas J, Nazzal M. Stent fracture in the brachiocephalic trunk. Vascular 2013; 21:261-5. [DOI: 10.1177/1708538113478775] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Stents are commonly used as a tool for revascularization of different vascular beds in the body. However, many pitfalls have been reported with their use, such as thrombosis, migration, restenosis or fractures. The latter have been strongly correlated to in-stent restenosis with long-term follow-up. We report a rare case of an early stent fracture in the brachiocephalic trunk with in-stent restenosis and recurrence of symptoms. To our knowledge there has been only one case report of a delayed brachiocephalic stent fracture in the English literature. We believe that our case is the first report of an early stent fracture in the brachiocephalic trunk.
Collapse
Affiliation(s)
- M Al-Natour
- Division of Vascular and Endovascular Surgery, The University of Toledo Medical Center, Toledo, OH, USA
| | - A Renno
- Division of Vascular and Endovascular Surgery, The University of Toledo Medical Center, Toledo, OH, USA
| | - M El-Fedaly
- Division of Vascular and Endovascular Surgery, The University of Toledo Medical Center, Toledo, OH, USA
| | - J Abbas
- Division of Vascular and Endovascular Surgery, The University of Toledo Medical Center, Toledo, OH, USA
| | - M Nazzal
- Division of Vascular and Endovascular Surgery, The University of Toledo Medical Center, Toledo, OH, USA
| |
Collapse
|
47
|
Ruegg WR, VanDis FJ, Feldman HJ, Mani K, Bronstein G, Moon JD, Brewer J. Aortic arch vessel disease and rationale for echocardiographic screening. J Am Soc Echocardiogr 2012; 26:114-25. [PMID: 23261149 DOI: 10.1016/j.echo.2012.11.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Indexed: 10/27/2022]
Abstract
Atherosclerosis of the proximal branches of the aortic arch has compelling clinical implications that warrant the application of direct noninvasive detection of the disease. The prevalence of aortic arch vessel disease in an aging and at-risk community and clinical population has been underreported and undertreated despite an associated increase of all-cause and cardiovascular mortality. Intrathoracic duplex imaging has been validated as an accurate noninvasive tool to detect, characterize, and follow native aortic arch vessel disease and its sequelae and correction. Such duplex techniques are easily integrated into routine echocardiography with focused training and minimal time investment in the examination. A paucity of available resources exists across disciplines regarding ultrasonographic investigation of these supra-aortic trunk vessels, including textbooks, journal articles, seminars, and manuals. This review has been compiled to familiarize physicians and sonographers with the relevant anatomy, pathophysiology, treatment, and diagnostic duplex surveillance of aortic arch vessel disease. Illustrative cases along with clinical rationale are discussed with the intent to facilitate the integration of arch vessel duplex imaging into the scope and practice of echocardiography.
Collapse
Affiliation(s)
- William R Ruegg
- Shaw Heart and Vascular Center at Mercy Medical Center, Roseburg, Oregon, USA.
| | | | | | | | | | | | | |
Collapse
|
48
|
Song LP, Zhang J. Axillo-axillary bypass with polytetrafluoroethylene graft for coronary subclavian steal syndrome. Vascular 2012; 20:188-92. [PMID: 22688926 DOI: 10.1258/vasc.2011.oa0344] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The purpose of this study is to report the results of axillo-axillary bypass (AAB) for coronary subclavian steal syndrome due to proximal subclavian artery occlusion. From 2003 to 2010, AAB using a polytetrafluoroethylene (PTFE) graft was performed in 11 patients with coronary subclavian steal syndrome. There was no perioperative mortality, stroke or cardiac complications. Over a mean follow-up of 36 months (range: 6–81 months), all bypass grafts have remained patent. No patient developed recurrent symptoms of myocardial ischemia. One patient died from hemorrhagic stroke at 31 months. Our results showed that AAB using a PTFE graft provides an effective and durable treatment option for coronary subclavian steal syndrome when attempted endovascular therapy of the occluded proximal subclavian artery is unsuccessful.
Collapse
Affiliation(s)
- Li Po Song
- Department of Vascular Surgery, XuanWu Hospital of Capital Medical University, Changchun Street No. 45, 100053 Beijing, China
| | - Jian Zhang
- Department of Vascular Surgery, XuanWu Hospital of Capital Medical University, Changchun Street No. 45, 100053 Beijing, China
| |
Collapse
|
49
|
Morris ME, Galiñanes EL, Nichols WK, Ross CB, Chauvupun J. Thoracic mural thrombi: a case series and literature review. Ann Vasc Surg 2012; 25:1140.e17-21. [PMID: 22023948 DOI: 10.1016/j.avsg.2011.05.030] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2011] [Revised: 05/02/2011] [Accepted: 05/03/2011] [Indexed: 11/24/2022]
Abstract
Thoracic mural thrombi (TMT) are rare but an important source of distal emboli. Treatment options are dynamic, ranging from open, endovascular to conservative therapies. We report two cases of TMT, one successfully treated with thoracic aortic endoluminal stent placement for visceral and peripheral embolization, the second treated conservatively for digital embolization secondary to TMT in the innominate artery.
Collapse
|
50
|
Cam A, Muhammad KI, Shishehbor MH, Bajzer CT, Kapadia SR. Technique and outcome of ostial common carotid artery stenting: a single centre experience. EUROINTERVENTION 2012; 7:1210-5. [DOI: 10.4244/eijv7i10a193] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|