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Takahashi Y, Higashida T, Uchida T, Watanabe S, Kanazawa R. Carotid endarterectomy with stent removal for recurring in-stent restenosis: A case report and literature review. Surg Neurol Int 2022; 13:192. [PMID: 35673638 PMCID: PMC9168307 DOI: 10.25259/sni_1222_2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 04/20/2022] [Indexed: 11/28/2022] Open
Abstract
Background: Percutaneous transcatheter angioplasty (PTA) and carotid artery stenting (CAS) are often performed repeatedly for in-stent restenosis (ISR) after CAS. Only a few reports describe the treatment for repeated ISR. Furthermore, only a few reports describe carotid endarterectomy (CEA) after CAS; thus, the evidence for this procedure is insufficient. Case Description: Herein, we describe a case in which CEA with stent removal was performed in a patient with repeated ISR after CAS. A 78-year-old man presented with dysarthria and slight left limb weakness. CAS was performed for the right internal carotid artery stenosis. ISR occurred again and PTA and stenting were performed. After the second CAS, ISR occurred again. CEA with stent removal was performed. After the CEA with stent removal, the patient experienced no restenosis or other complications. Conclusion: CEA with stent removal can be a good option for treating repeated ISR after CAS.
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Stilo F, Sirignano P, Montelione N, Mansour W, Capoccia L, Catanese V, Spinelli F, Speziale F. Bypass for symptomatic in-stent carotid restenosis. Int J Cardiol 2017; 249:392-395. [DOI: 10.1016/j.ijcard.2017.09.166] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Revised: 07/08/2017] [Accepted: 09/18/2017] [Indexed: 10/18/2022]
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Cobb MIPH, Smith TP, Brown PA, Gonzalez LF, Zomorodi AR. Carotid Endarterectomy to Remove Retained Solitaire Stent Retriever inside Carotid Stent after Mechanical Thrombectomy. J Stroke Cerebrovasc Dis 2017; 26:e90-e95. [PMID: 28318956 DOI: 10.1016/j.jstrokecerebrovasdis.2017.02.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 01/25/2017] [Accepted: 02/09/2017] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND Tandem occlusions of the internal carotid artery (ICA) and middle cerebral artery (MCA) occur in up to a third of patients with acute ischemic strokes undergoing endovascular mechanical thrombectomy. Understanding open neurosurgical management of associated complications with this procedure is important. CASE REPORT A 67-year-old man with acute onset of left hemiparesis and a tandem right ICA and MCA occlusion. He underwent carotid stent angioplasty of a stenotic ICA, followed by attempted Solitaire stent retrieval of an MCA clot. On withdrawal, the tines of the Solitaire stent lodged inside the Precise carotid stent. The patient was started on aspirin, Plavix, and heparin infusion, and underwent a carotid endarterectomy (CEA) with safe removal of the stents and primary vessel repair. CONCLUSION This is the first case reported to date of a Solitaire stent becoming lodged inside a Precise carotid stent, salvaged by CEA with safe removal of the stents and primary vessel repair. We discuss the timing, indication, alternatives, and technical nuances of a CEA in this setting.
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Affiliation(s)
| | - Tony P Smith
- Duke University Hospitals, Department of Radiology, Division of Interventional Radiology, Durham, North Carolina
| | - Patrick A Brown
- Duke University Hospitals, Department of Radiology, Division of Interventional Radiology, Durham, North Carolina
| | - L Fernando Gonzalez
- Duke University Hospitals, Department of Neurosurgery, Durham, North Carolina
| | - Ali R Zomorodi
- Duke University Hospitals, Department of Neurosurgery, Durham, North Carolina
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Pourier VE, de Borst GJ. Technical options for treatment of in-stent restenosis after carotid artery stenting. J Vasc Surg 2016; 64:1486-1496. [DOI: 10.1016/j.jvs.2016.07.106] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 07/04/2016] [Indexed: 11/30/2022]
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Qiao Y, Tang C, Wang Q, Wang D, Yan G, Zhu B. Kir2.1 regulates rat smooth muscle cell proliferation, migration, and post-injury carotid neointimal formation. Biochem Biophys Res Commun 2016; 477:774-780. [PMID: 27387235 DOI: 10.1016/j.bbrc.2016.06.134] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Accepted: 06/26/2016] [Indexed: 12/15/2022]
Abstract
Phenotype switching of vascular smooth muscle cells (VSMC) from the contractile type to the synthetic type is a hallmark of vascular disorders such as atherosclerosis and restenosis after angioplasty. Inward rectifier K(+) channel 2.1 (Kir2.1) has been identified in VSMC. However, whether it plays a functional role in regulating cellular transformation remains obscure. In this study, we evaluated the role of Kir2.1 on VSMC proliferation, migration, phenotype switching, and post-injury carotid neointimal formation. Kir2.1 knockdown significantly suppressed platelet-derived growth factor BB-stimulated rat vascular smooth muscle cells (rat-VSMC) proliferation and migration. Deficiency in Kir2.1 contributed to the restoration of smooth muscle α-actin, smooth muscle 22α, and calponin and to a reduction in osteopontin expression in rat-VSMC. Moreover, the in vivo study showed that rat-VSMC switched to proliferative phenotypes and that knockdown of Kir2.1 significantly inhibited neointimal formation after rat carotid injury. Kir2.1 may be a potential therapeutic target in the treatment of cardiovascular diseases, such as atherosclerosis and restenosis following percutaneous coronary intervention.
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Affiliation(s)
- Yong Qiao
- Department of Cardiology, Zhongda Hospital of Southeast University Medical School, Nanjing, Jiangsu, China
| | - Chengchun Tang
- Department of Cardiology, Zhongda Hospital of Southeast University Medical School, Nanjing, Jiangsu, China.
| | - Qingjie Wang
- Department of Cardiology, Zhongda Hospital of Southeast University Medical School, Nanjing, Jiangsu, China
| | - Dong Wang
- Department of Cardiology, Zhongda Hospital of Southeast University Medical School, Nanjing, Jiangsu, China
| | - Gaoliang Yan
- Department of Cardiology, Zhongda Hospital of Southeast University Medical School, Nanjing, Jiangsu, China
| | - Boqian Zhu
- Department of Cardiology, Zhongda Hospital of Southeast University Medical School, Nanjing, Jiangsu, China
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Giordano A, Ferraro P, Corcione N, Messina S, Maresca G, Coscioni E, Biondi-Zoccai G. Successful treatment of recurrent carotid in-stent restenosis and drug-eluting balloon failure with a coronary bioresorbable vascular scaffold: A case report. Int J Surg Case Rep 2016; 21:78-82. [PMID: 26945488 PMCID: PMC4802336 DOI: 10.1016/j.ijscr.2016.02.035] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 02/23/2016] [Accepted: 02/24/2016] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Carotid in-stent restenosis is associated with substantial risk of recurrent restenosis, even after drug-eluting balloon usage. PRESENTATION OF CASE We hereby report the case of a patient with recurrent carotid in-stent restenosis and drug-eluting balloon failure treated with a coronary bioresorbable vascular scaffold, achieving a satisfactory acute and long-term result, as disclosed by duplex ultrasound scan performed more than 1 year after the procedure. DISCUSSION/CONCLUSION While awaiting for external validation, this clinical vignette supports expanding the armamentarium of endovascular specialists focusing on carotid artery disease, while providing further proof of the safety and efficacy of current bioresorbable vascular scaffolds.
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Affiliation(s)
- Arturo Giordano
- Unità Operativa di Interventistica Cardiovascolare, Presidio Ospedaliero Pineta Grande, Castel Volturno, Italy; Unità Operativa di Emodinamica, Casa di Salute Santa Lucia, San Giuseppe Vesuviano, Italy
| | - Paolo Ferraro
- Unità Operativa di Interventistica Cardiovascolare, Presidio Ospedaliero Pineta Grande, Castel Volturno, Italy; Unità Operativa di Emodinamica, Casa di Salute Santa Lucia, San Giuseppe Vesuviano, Italy
| | - Nicola Corcione
- Unità Operativa di Interventistica Cardiovascolare, Presidio Ospedaliero Pineta Grande, Castel Volturno, Italy; Unità Operativa di Emodinamica, Casa di Salute Santa Lucia, San Giuseppe Vesuviano, Italy
| | - Stefano Messina
- Unità Operativa di Interventistica Cardiovascolare, Presidio Ospedaliero Pineta Grande, Castel Volturno, Italy; Unità Operativa di Emodinamica, Casa di Salute Santa Lucia, San Giuseppe Vesuviano, Italy
| | - Gennaro Maresca
- Unità Operativa di Interventistica Cardiovascolare, Presidio Ospedaliero Pineta Grande, Castel Volturno, Italy; Unità Operativa di Emodinamica, Casa di Salute Santa Lucia, San Giuseppe Vesuviano, Italy
| | - Enrico Coscioni
- Division of Cardiac Surgery, San Giovanni di Dio e Ruggì D'Aragona Hospital, Salerno, Italy
| | - Giuseppe Biondi-Zoccai
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy; Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy.
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Akingba AG, Bojalian M, Shen C, Rubin J. Managing Recurrent Carotid Artery Disease with Redo Carotid Endarterectomy: A 10-year Retrospective Case Series. Ann Vasc Surg 2014; 28:908-16. [DOI: 10.1016/j.avsg.2013.07.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Revised: 07/02/2013] [Accepted: 07/11/2013] [Indexed: 10/26/2022]
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Zheng J, Liu L, Cao Y, Zhang D, Wang R, Zhao J. Carotid Endarterectomy with Stent Removal in Management of In-stent Restenosis: A Safe, Feasible, and Effective Technique. Eur J Vasc Endovasc Surg 2014; 47:8-12. [DOI: 10.1016/j.ejvs.2013.10.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Accepted: 10/13/2013] [Indexed: 10/26/2022]
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Ringleb P, Görtler M, Nabavi D, Arning C, Sander D, Eckstein HH, Kühnl A, Berkefeld J, Diel R, Dörfler A, Kopp I, Langhoff R, Lawall H, Storck M. S3-Leitlinie Extracranielle Carotisstenose. GEFÄSSCHIRURGIE 2012. [DOI: 10.1007/s00772-012-1052-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Reichmann BL, van Laanen JH, de Vries JPP, Hendriks JM, Verhagen HJ, Moll FL, de Borst GJ. Carotid endarterectomy for treatment of in-stent restenosis after carotid angioplasty and stenting. J Vasc Surg 2011; 54:87-92. [DOI: 10.1016/j.jvs.2010.11.118] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2010] [Revised: 11/24/2010] [Accepted: 11/24/2010] [Indexed: 12/20/2022]
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Eversion Carotid Endarterectomy for Recurrent Stenosis After Carotid Angioplasty/Stenting. Ann Vasc Surg 2011; 25:555.e1-3. [DOI: 10.1016/j.avsg.2010.12.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2010] [Accepted: 12/26/2010] [Indexed: 11/20/2022]
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Jost D, Meissner H, von Loewensprung H, Guethe T, Hupp T, Henkes H. Successful interdisciplinary management of the misdeployment of two self-expanding stents into the internal carotid artery: a case report. J Med Case Rep 2010; 4:397. [PMID: 21143886 PMCID: PMC3016301 DOI: 10.1186/1752-1947-4-397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2010] [Accepted: 12/09/2010] [Indexed: 11/14/2022] Open
Abstract
Introduction With the widespread use of carotid artery stenting, previously unknown technical mistakes of this treatment modality are now being encountered. There are multiple strategies for the treatment of in-stent restenosis. With regard to surgical management, endarterectomy and patch plasty are favored. To the best of our knowledge, this report is the first description of a complete stent removal by the eversion technique. Case presentation We report the case of a 63-year-old Caucasian man with misdeployment of two stents into his stenotic proximal internal carotid artery, resulting in a high-grade mechanical obstruction of the internal carotid artery lumen. With the contralateral internal carotid artery already occluded and associated stenoses of both proximal and distal vertebral arteries, an interdisciplinary therapeutic concept was applied. Bilateral balloon angioplasty and stenting of the proximal and distal stenotic vertebral arteries were carried out to provide sufficient posterior collateral blood flow, followed by successful surgical stentectomy and carotid endarterectomy using the eversion technique. Duplex scanning and neurological assessments were normal over a 12-month follow-up period. Conclusions Interdisciplinary treatment is a recommended option to protect patients from further impairment. Further evaluation in larger studies is highly recommended.
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Affiliation(s)
- Dominik Jost
- Department of Vascular Surgery, Klinikum Stuttgart, Stuttgart, Germany.
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van Haaften AC, Bots ML, Moll FL, de Borst GJ. Therapeutic Options for Carotid In-stent Restenosis: Review of the Literature. J Vasc Interv Radiol 2010; 21:1471-7. [DOI: 10.1016/j.jvir.2010.06.010] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2009] [Revised: 05/31/2010] [Accepted: 06/26/2010] [Indexed: 11/17/2022] Open
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Carotid artery interventions for restenosis after prior stenting: is it different from interventions of de novo lesions? Results from the carotid artery stent (CAS)--registry of the Arbeitsgemeinschaft Leitende Kardiologische Krankenhausärzte (ALKK). Clin Res Cardiol 2010; 99:809-15. [PMID: 20596714 DOI: 10.1007/s00392-010-0188-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2010] [Accepted: 06/17/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To compare characteristics and outcome of patients with re-stenoses after prior carotid artery stenting (CAS) treated with repeat carotid interventions (Re-CI) with CAS for de novo lesions. BACKGROUND The treatment of re-stenosis is a major problem in vascular interventions. Patients with re-stenoses after prior CAS treated with Re-CI are not well defined. METHODS We analyzed data from the prospective ALKK CAS Registry. RESULTS Out of 3,817 CAS procedures 95 were intended in 93 patients (2.5%) for a restenosis after prior CAS and 3,722 CAS in 3,655 patients (97.5%) for a de novo stenosis. There was no difference in age (p = 0.302) or distribution of gender (p = 0.545) between the two groups. Patients treated for a restenosis after CAS were less likely to be treated for a symptomatic lesion (22.7 vs. 40.1%, p = 0.001). Coronary heart disease (p = 0.017), peripheral arterial disease (p < 0.001) as well as diabetes mellitus (p = 0.004) were more prevalent in the restenosis group. Lesions were less complicated in restenosis patients, with less ulcers (7.4 vs. 19.9%, p = 0.003) and less severe calcifications (7.4 vs. 23.6%, p < 0.001). The intended interventions were more often not performed in the Re-CI group (9.5 vs. 3.3%; p = 0.001). In-hospital, the stroke or death rate was 0% in the Re-CI group as compared to 3.1% in the de novo group (p = 0.115). CONCLUSIONS Patients treated with Re-CI for repeat stenoses after prior CAS represent 2.5% of current CAS patients. Although representing a subgroup with more concomitant diseases, Re-CI seems to be associated with lower event rates as compared to CAS for de novo lesions.
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