OBJECTIVE: The surgical benefit to pseudo-occlusion of the internal carotid artery (ICA) is controversial. Because the benefit of carotid endarterectomy for pseudo-occlusion of the ICA remains uncertain, we examined the use of carotid stenting as a possible alternative treatment for this condition. METHODS: Twenty cases of carotid pseudo-occlusion (17 symptomatic, three asymptomatic) were treated with carotid artery stenting. Nineteen patients were treated with various embolic protection techniques. Our clinical results, including angiographic follow-up data, perioperative complications, and data on the effectiveness of the embolic protection methods were studied for ICA pseudo-occlusion. RESULTS: All pseudo-occlusions were successfully dilated, and the stenotic ratio was reduced from 95 to 6.7% on average. No neurological deterioration was encountered in any of the cases, although one patient died of cardiac event 1 day after treatment. None of the patients experienced stroke during the mean 24.8 month follow-up period, although one patient died from myocardial infarction. Among the 17 cases in which follow-up angiography was performed at 6 months after stenting, only one patient demonstrated restenosis. This patient was successfully treated with repeated percutaneous transluminal angioplasty. The rate of restenosis in our series was 5.9%, and the morbidity/mortality rate within 30 days was 5%. CONCLUSION: The clinical results of carotid stenting for ICA pseudo-occlusion under embolic protection were fairly good from the viewpoints of periprocedural neurological morbidity, angiographic follow-up results, and stroke prevention. Carotid stenting can be considered an alternative to carotid endarterectomy in patients with ICA pseudo-occlusion.
OBJECTIVE: The surgical benefit to pseudo-occlusion of the internal carotid artery (ICA) is controversial. Because the benefit of carotid endarterectomy for pseudo-occlusion of the ICA remains uncertain, we examined the use of carotid stenting as a possible alternative treatment for this condition. METHODS: Twenty cases of carotid pseudo-occlusion (17 symptomatic, three asymptomatic) were treated with carotid artery stenting. Nineteen patients were treated with various embolic protection techniques. Our clinical results, including angiographic follow-up data, perioperative complications, and data on the effectiveness of the embolic protection methods were studied for ICA pseudo-occlusion. RESULTS: All pseudo-occlusions were successfully dilated, and the stenotic ratio was reduced from 95 to 6.7% on average. No neurological deterioration was encountered in any of the cases, although one patient died of cardiac event 1 day after treatment. None of the patients experienced stroke during the mean 24.8 month follow-up period, although one patient died from myocardial infarction. Among the 17 cases in which follow-up angiography was performed at 6 months after stenting, only one patient demonstrated restenosis. This patient was successfully treated with repeated percutaneous transluminal angioplasty. The rate of restenosis in our series was 5.9%, and the morbidity/mortality rate within 30 days was 5%. CONCLUSION: The clinical results of carotid stenting for ICA pseudo-occlusion under embolic protection were fairly good from the viewpoints of periprocedural neurological morbidity, angiographic follow-up results, and stroke prevention. Carotid stenting can be considered an alternative to carotid endarterectomy in patients with ICA pseudo-occlusion.
Authors: B S Choi; J W Park; J E Shin; P-H Lü; J K Kim; S J Kim; D H Lee; J S Kim; H J Kim; D C Suh Journal: Interv Neuroradiol Date: 2010-10-25 Impact factor: 1.610
Authors: A González; A Gil-Peralta; A Mayol; J R Gonzalez-Marcos; F Moniche; M Aguilar; I Gutierrez Journal: AJNR Am J Neuroradiol Date: 2010-11-04 Impact factor: 3.825
Authors: Stephan A Munich; Marshall C Cress; Leonardo Rangel-Castilla; Ashish Sonig; Chandan Krishna; Elad I Levy; Kenneth V Snyder; Adnan H Siddiqui Journal: J Vasc Interv Neurol Date: 2018-06