Carotid angioplasty with internal carotid artery flow reversal is well tolerated in the awake patient

Journal of Vascular Surgery
E CriadoL Philipp Wall

Abstract

The purpose of this study was to evaluate the neurologic tolerance and changes in ipsilateral hemispheric oxygen saturation during transcervical carotid artery stenting with internal carotid artery (ICA) flow reversal for embolic protection. This was a prospective study of 10 patients (mean age 68 years) undergoing transcervical carotid angioplasty and stenting. All ICA stenoses were greater that 70%. Seven patients had an ipsilateral hemispheric stroke (3) or transient ischemic attack (4), two patients had a contralateral stroke, and one patient was asymptomatic. Nine procedures were done under local anesthesia. Cerebral protection was established through a cervical common carotid (CCA) cutdown to create an external fistula between the ICA and the internal jugular vein with temporally CCA occlusion. Venous oxygen saturation (SVO(2)) was continuously monitored through a catheter placed in the distal internal jugular vein. Mental status and motor-sensory changes were categorized and assessed throughout and after the procedure. All procedures were technically successful without significant residual stenosis. Mean ICA flow reversal time was 22 minutes (range, 15 to 32). Common carotid artery (CCA) occlusion produced a slight (SVO(...Continue Reading

References

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Citations

Sep 4, 2012·Journal of Neuroradiology. Journal De Neuroradiologie·Luis Henrique de Castro-AfonsoDaniel Giansante Abud
Jan 24, 2006·Surgical Neurology·Ian B Ross, Gustavo D Luzardo
Apr 20, 2005·Journal of Vascular Surgery·Juan C ParodiSamuel Fernandez
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Sep 22, 2010·International Journal of Nursing Practice·Deborah Norton-WestwoodRita Anderson
Jul 29, 2005·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Iraklis I PipinosThomas G Lynch
Apr 13, 2005·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Juan C Parodi
Nov 7, 2019·Jornal Vascular Brasileiro·Rafael Demarchi Malgor, Rasesh Mahendra Shah
Apr 18, 2021·Journal of Vascular Surgery·Marios SagrisChristos Bakoyiannis

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