Prophylactic Dual Catheter Technique to Prevent Side Branch Snowplowing Complications during Angioplasty and Stenting

Journal of Cerebrovascular and Endovascular Neurosurgery
Leonard L L YeoH F Wong

Abstract

Angioplasty and Stenting of intracranial atherosclerotic lesions have a higher complication rate and a large proportion of this is attributable to side branch arterial occlusion from forceful displacement of the atheroma into the ostia or snowplowing effect. This can result in severe disabilities when it result in small infarcts involving eloquent areas in the posterior circulation or the motor tracts. We present a series of 6 cases utilizing a new dual catheter technique for maintaining the patency of at-risk vessels during angioplasty and stenting. There are several methods previously described to help reduce the incidence of stroke but because they do not have a physical presence in the ostia to protect it, they are unable to guarantee the patency of the vessel. All 6 patients underwent angioplasty and stenting with the technique. The patients were assessed for complications with post-procedure magnetic resonance imaging and no complications were found. In this preliminary series, the dual catheter technique appears to safe and effective in preventing occlusion of the adjacent branch arteries. This technique may facilitate the use of the Wingspan stent in the treatment of intracranial atherosclerotic stenotic segments by red...Continue Reading

References

Feb 2, 2002·Stroke; a Journal of Cerebral Circulation·Ka Sing WongRichard Kay
Mar 30, 2002·American Heart Journal·Tudor C PoernerKarl K Haase
Mar 27, 2003·Neuroepidemiology·UNKNOWN Warfarin-Aspirin Symptomatic Intracranial Disease (WASID) Trial Investigators
May 24, 2003·Neurosurgery·Demetrius Klee LopesL Nelson Hopkins
Apr 23, 2004·Journal of Vascular and Interventional Radiology : JVIR·H Christian SchumacherRandall T Higashida
Apr 1, 2005·The New England Journal of Medicine·Marc I ChimowitzUNKNOWN Warfarin-Aspirin Symptomatic Intracranial Disease Trial Investigators
Jun 28, 2006·Neurology·Elad I Levy, Seemant Chaturvedi
Feb 2, 2008·Stroke; a Journal of Cerebral Circulation·Fadi NahabUNKNOWN WASID Study Group
Aug 19, 2008·International Journal of Stroke : Official Journal of the International Stroke Society·Lawrence K S Wong
Feb 3, 2009·Stroke; a Journal of Cerebral Circulation·Thomas W LeungLawrence K S Wong
Mar 21, 2009·Neurology·F NahabUNKNOWN NIH Multicenter Wingspan Intracranial Stent Registry Study Group
Sep 9, 2011·The New England Journal of Medicine·Marc I ChimowitzUNKNOWN SAMMPRIS Trial Investigators
Jan 9, 2016·Journal of Neurosurgery·Travis M DumontAdnan H Siddiqui

❮ Previous
Next ❯

Citations

Dec 29, 2020·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Mostafa JafariAfshin A Divani
Aug 20, 2021·Annals of Vascular Surgery·Andrew H SmithChristopher J Smolock

❮ Previous
Next ❯

Methods Mentioned

BETA
dissection

Software Mentioned

SAMMPRIS

Related Concepts

Related Feeds

Atherosclerosis Disease Progression

Atherosclerosis is the buildup of plaque on artery walls, causing stenosis which can eventually lead to clinically apparent cardiovascular disease. Find the latest research on atherosclerosis disease progression here.