Safety and efficacy of an open-cell stent and double-balloon protection for unstable plaques: analysis of 184 consecutive carotid artery stentings
| Autor: | Ryo Akiyama, Masashi Shigeyasu, Yusuke Funakoshi, Koji Iihara, Yuichi Matsui, Tadashi Sunohara, Shoichi Tani, Hirotoshi Imamura, Shinji Kajiura, Yoshihiro Omura, Kazufumi Horiuchi, Ryu Fukumitsu, Hidemitsu Adachi, Natsuhi Sasaki, Tatsumaru Fukuda, Nobuyuki Sakai |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Carotid arteries medicine.medical_treatment Balloon Asymptomatic Lesion Humans Medicine Carotid Stenosis Stroke Aged Ultrasonography business.industry Stent General Medicine Perioperative medicine.disease Plaque Atherosclerotic Stenosis Treatment Outcome Female Stents Surgery Neurology (clinical) Radiology medicine.symptom business |
| Zdroj: | Journal of NeuroInterventional Surgery. 12:758-762 |
| ISSN: | 1759-8486 1759-8478 |
| DOI: | 10.1136/neurintsurg-2019-015393 |
| Popis: | IntroductionIn our institute, most cases of carotid artery stenosis are treated by carotid artery stenting (CAS) with an open-cell stent and double-balloon protection, even if plaques are unstable. This study was performed to examine the outcome of CAS with an open-cell stent and double-balloon protection for unstable plaques.MethodsA total of 184 CAS procedures in our institute between October 2010 and February 2018 were assessed. Ultrasonography findings of low-echo plaques, plaque ulceration, or both were defined as unstable plaques. A plaque-to-muscle ratio (PMR) of >1.8 on T1-weighted black blood imaging using spin-echo was also defined as an unstable plaque. Seventy-four unstable plaques on ultrasonography and 86 unstable plaques evaluated by PMR were included. Open-cell stents and double-balloon protection (proximal balloon protection during lesion crossing and distal balloon protection after lesion crossing) were used in all cases.ResultsOn ultrasonography, perioperative asymptomatic thromboembolization was significantly more frequent in the unstable plaque group (39/74, 52.7%) than in the stable plaque group (41/110, 37.3%, p=0.0384). Asymptomatic thromboembolization was also significantly more frequent in the PMR >1.8 group (44/86, 51.2%) than in the PMR ConclusionsThe outcomes of CAS with an open-cell stent and double-balloon protection are acceptable. This method is effective and safe, even if carotid artery stenosis comprises unstable plaques. |
| Databáze: | OpenAIRE |
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