Author:
Balázs Nemes
Balázs Nemes
Heart Center, Semmelweis University, Városmajor u. 68, H-1122, Budapest, Hungary
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Abstract
Cerebrovascular disease, including stroke, represents the third-leading cause of death in Hungary and a leading cause of disability among the elderly population. The majority of all strokes are ischemic, mostly secondary to thromboembolic disease of the supraaortic vessels. We investigated new therapeutic methods in the endovascular treatment of these diseases. Surgical revascularization of supraaortic trunk stenosis is associated with high morbidity and mortality rates. Balloon angioplasty has become an increasingly accepted treatment of stenoocclusive supraaortic arterial disease. Natural history data and treatment guidelines do not exist for innominate and proximal common carotid artery lesions. We have confirmed in a large series of innominate artery angioplasties that it is a safe and effective procedure with an excellent initial success rate, with a lower complication rate than the surgical option and with a similar long-term patency rate as for surgery.
In the largest published study on transfemoral angioplasty of ostial and proximal common carotid artery stenosis we have proved that endovascular treatment has high success rate with low stroke/death rate. Carotid stenting (CAS) is an evolving alternative to surgery in the treatment of patients with carotid stenosis. Stent selection is influenced by several factors, including the carotid anatomy and lesion characteristics. We examined the wall adaptability of a new closed-cell carotid stent (NexStent), which was designed for carotid bifurcation treatment. Data obtained from angiographic and computed tomographic images indicate that the stent provides adequate expansion and adaptation to the carotid bifurcation.
There are two types of restenosis after carotid artery interventions: the early restenosis develops mainly within the first 24 months after the revascularization procedure and its pathological background is myointimal hyperplasia; on the other hand late restenosis is rather due to progression of primary atherosclerosis and occurs more than 2 years after carotid endarterectomy (CEA). We compared the early restenosis rate in a consecutive series of CAS versus CEA patients at a single cardiovascular institution. The data suggest that the incidence of restenosis after stenting was less common than after surgery.
Our results may help vascular surgeons and interventional radiologists to consider risk versus benefit when deciding treatment options for supraaortic arterial stenosis.
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-
1. J.P. Mohr et al.1978 The Harvard Cooperative Stroke Registry: a prospective registry Neurology 28 754 762.
-
2. Z. Nagy et al.2000 Magyarországi stroke-betegek epidemiológiai vizsgálata Agyérbetegségek 6 2 10.
-
3. S.C. Johnston et al.2007 Validation and refinement of scores to predict very early stroke risk after transient ischaemic attack Lancet 369 283 292.
-
4. R. Berguer et al.1998 Transthoracic repair of innominate and common carotid artery disease: immediate and long-term outcome for 100 consecutive surgical reconstructions J Vasc Surg 27 34 41.
-
5. D.C. Brewster et al.1985 Innominate artery lesions: problems encountered and lessons learned J Vasc Surg 2 99 112.
-
6. K.J. Cherry Jr et al.1989 Technical principles of direct innominate artery revascularization: a comparison of endarterectomy and bypass grafts J Vasc Surg 9 718 723.
-
7. D. Melliere et al.1992 Atherosclerotic disease of the innominate artery: current management and results J Cardiovasc Surg (Torino) 33 319 323.
-
8. M. Herring 1977 The subclavian steal syndrome: a review Am Surg 43 220 228.
-
9. A. Azakie et al.1998 Innominate artery reconstruction: over 3 decades of experience Ann Surg 228 402 410.
-
10. E. Kieffer et al.1995 Atherosclerotic innominate artery occlusive disease: early and long-term results of surgical reconstruction J Vasc Surg 21 326 336.
-
11. A. Motarjeme et al.1982 Percutaneous transluminal angioplasty of the brachiocephalic arteries AJR Am J Roentgenol 138 457 462.
-
12. J. Theron et al.1984 Angioplasty of supraaortic arteries J Neuroradiol 11 187 200.
-
13. Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. 1991 North American Symptomatic Carotid Endarterectomy Trial Collaborators N Engl J Med 325 445 453.
-
14. Randomised trial of endarterectomy for recently symptomatic carotid stenosis: final results of the MRC European Carotid Surgery Trial 1998 Lancet 351 1379 1387.
-
15. Endarterectomy for asymptomatic carotid artery stenosis. 1995 Executive Committee for the Asymptomatic Carotid Atherosclerosis Study JAMA 273 1421 1428.
-
16. A. Halliday et al.2004 Prevention of disabling and fatal strokes by successful carotid endarterectomy in patients without recent neurological symptoms: randomised controlled trial Lancet 363 1491 1502.
-
17. C.W. Kerber et al.1980 Catheter dilatation of proximal carotid stenosis during distal bifurcation endarterectomy AJNR Am J Neuroradiol 1 348 349.
-
18. F.Y. Tsai et al.1986 Percutaneous transluminal angioplasty of the carotid artery AJNR Am J Neuroradiol 7 349 358.
-
19. G. Freitag et al.1984 Percutaneous transluminal angioplasty of carotid stenoses] Röfo 140 209 212.
-
20. R. Kachel et al.1987 Percutaneous transluminal angioplasty (dilatation) of carotid, vertebral, and innominate artery stenoses Cardiovasc Intervent Radiol 10 142 146.
-
21. Endovascular versus surgical treatment in patients with carotid stenosis in the CarotidVertebral Artery Transluminal Angioplasty Study 2001 Lancet 357 1729 1737.
-
22. J.S. Yadav et al.2004 Protected carotid-artery stenting versus endarterectomy in high-risk patients N Engl JMed 351 1493 1501.
-
23. J.L. Mas et al.2006 Endarterectomy versus stenting in patients with symptomatic severe carotid stenosis N Engl J Med 355 1660 1671.
-
24. H.H. Eckstein et al.2008 Results of the Stent-Protected Angioplasty versus Carotid Endarterectomy (SPACE) study to treat symptomatic stenoses at 2 years: a multinational, prospective, randomised trial Lancet Neurol 7 893 902.
-
25. P. Meier et al.2010 Short term and intermediate term comparison of endarterectomy versus stenting for carotid artery stenosis: systematic review and meta-analysis of randomised controlled clinical trials BMJ 340 c467.
-
26. R.L. Insall et al.1990 Percutaneous transluminal angioplasty of the innominate, subclavian, and axillary arteries Eur J Vasc Surg 4 591 595.
-
27. R. Maggisano J.L. Provan 1981 Surgical management of chronic occlusive disease of the aortic arch vessels and vertebral arteries Can Med Assoc J 124 972 977.
-
28. R.L. Sacco et al.2006 Guidelines for prevention of stroke in patients with ischemic stroke or transient ischemic attack: a statement for healthcare professionals from the American Heart Association/ American Stroke Association Council on Stroke: co-sponsored by the Council on Cardiovascular Radiology and Intervention: the American Academy of Neurology affirms the value of this guideline Circulation 113 e409 e449.
-
29. A.M. McKinney et al.2005 Carotid bifurcation calcium and correlation with percent stenosis of the internal carotid artery on CT angiography Neuroradiology 47 1 9.
-
30. O.E. Elgersma et al.1998 Changes over time in optimal duplex threshold for the identification of patients eligible for carotid endarterectomy Stroke 29 2352 2356.
-
31. P.M. Rothwell et al.2003 Analysis of pooled data from the randomised controlled trials of endarterectomy for symptomatic carotid stenosis Lancet 361 107 116.
-
32. B.K. Lal et al.2004 Carotid artery stenting: is there a need to revise ultrasound velocity criteria? J Vasc Surg 39 58 66.
-
33. A. Motarjeme 1996 Percutaneous transluminal angioplasty of supra-aortic vessels J Endovasc Surg 3 171 181.
-
34. G. Dorros et al.1990 Peripheral transluminal angioplasty of the subclavian and innominate arteries utilizing the brachial approach: acute outcome and follow-up Cathet Cardiovasc Diagn 19 71 76.
-
35. L.A. Queral F.J. Criado 1996 The treatment of focal aortic arch branch lesions with Palmaz stents J Vasc Surg 23 368 375.
-
36. T.M. Sullivan et al.1998 Angioplasty and primary stenting of the subclavian, innominate, and common carotid arteries in 83 patients J Vasc Surg 28 1059 1065.
-
37. J.J. Vitek et al.1984 Innominate artery angioplasty AJNR Am J Neuroradiol 5 113 114.
-
38. A. Motarjeme G. Gordon 1993 Percutaneous transluminal angioplasty of the brachiocephalic vessels: Guidelines for therapy Int Angiol 12 260 269.
-
39. B. Nemes et al.1998 PTA and surgical revascularisation of the innominate artery Cardiovasc Intervent Radiol 21 Suppl1 S128.
-
40. R. Berguer et al.1999 Cervical reconstruction of the supra-aortic trunks: a 16-year experience J Vasc Surg 29 239 246.
-
41. F.L. Chio Jr et al.2003 Effectiveness of elective stenting of common carotid artery lesions in preventing stroke Am J Cardiol 92 1135 1137.
-
42. M.H. Wholey et al.2003 Carotid artery stent placement-ready for prime time? J Vasc Interv Radiol 14 1 10.
-
43. J. Berkefeld et al.2002 Recanalization results after carotid stent placement AJNR Am J Neuroradiol 23 113 120.
-
44. N. Tanaka et al.2004 Conformity of carotid stents with vascular anatomy: evaluation in carotid models AJNR Am J Neuroradiol 25 604 607.
-
45. M. Bosiers et al.2007 Does free cell area influence the outcome in carotid artery stenting? Eur J Vasc Endovasc Surg 33 135 141.
-
46. J.P. Hart et al.2006 Do device characteristics impact outcome in carotid artery stenting? J Vasc Surg 44 725 730.
-
47. M. Schillinger et al.2008 Does carotid stent cell design matter? Stroke 39 905 909.
-
48. H. Kaneda et al.2006 Long-term histopathologic and IVUS evaluations of a novel coiled sheet stent in porcine carotid arteries Cardiovasc Intervent Radiol 29 413 419.
-
49. G.C. Hunter J. Edgar 1997 Poth Memorial/W.L. Gore and Associates, Inc. Lectureship. The clinical and pathological spectrum of recurrent carotid stenosis Am J Surg 174 583 588.
-
50. V. Trisal et al.2002 Carotid artery restenosis: an ongoing disease process Am Surg 68 275 279.
-
51. C. Setacci et al.2005 In-stent restenosis after carotid angioplasty and stenting: a challenge for the vascular surgeon Eur J Vasc Endovasc Surg 29 601 607.
-
52. K. Ouriel et al.2001 Preprocedural risk stratification: identifying an appropriate population for carotid stenting J Vasc Surg 33 728 732.
-
53. M.L. Robbin et al.1997 Carotid artery stents: early and intermediate follow-up with Doppler US Radiology 205 749 756.
-
54. A. Willfort-Ehringer et al.2002 Single-center experience with carotid stent restenosis J Endovasc Ther 9 299 307.
-
55. C. Setacci et al.2003 Determinants of in-stent restenosis after carotid angioplasty: a case-control study J Endovasc Ther 10 1031 1038.
-
56. P. Cao et al.2000 Eversion versus conventional carotid endarterectomy: late results of a prospective multicenter randomized trial J Vasc Surg 31 19 30.
-
57. T. Reina-Gutierrez et al.2005 Recurrent carotid artery stenosis following endarterectomy: natural history and risk factors Eur J Vasc Endovasc Surg 29 334 341.
-
58. H. Sadideen et al.2006 Restenosis after carotid endarterectomy Int J Clin Pract 60 1625 1630.
-
59. B. Hugl et al.2006 Effect of age and gender on restenosis after carotid endarterectomy Ann Vasc Surg 20 602 608.
-
60. L.A. Malek et al.2005 Carotid clamping time as a risk factor for early restenosis after carotid endarterectomy Eur J Vasc Endovasc Surg 30 143 146.
-
61. A. Szabó et al.2007 Early rise in serum VEGF and PDGF levels predisposes patients with a normal MBL2 genotype to restenosis after eversion endarterectomy Stroke 38 2247 2253.
-
62. G. Széplaki et al.2008 Early complement activation follows eversion carotid endarterectomy and correlates with the time of clamping of the carotid artery Mol Immunol 45 3289 3294.
| 2019 | |
|---|---|
| Scimago H-index |
11 |
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0,220 |
| Scimago Quartile Score |
Medicine (miscellaneous) Q3 |
| Scopus Cite Score |
155/133=1,2 |
| Scopus Cite Score Rank |
General Medicine 199/529 (Q2) |
| Scopus SNIP |
0,343 |
| Scopus Cites |
206 |
| Scopus Documents |
23 |
| Interventional Medicine and Applied Science | |
|---|---|
| Language | English |
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| Year of Foundation |
2009 |
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changed title |
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| Founder | Akadémiai Kiadó |
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H-1117 Budapest, Hungary 1516 Budapest, PO Box 245. |
| Publisher | Akadémiai Kiadó |
| Publisher's Address |
H-1117 Budapest, Hungary 1516 Budapest, PO Box 245. |
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| ISSN | 2061-1617 (Print) |
| ISSN | 2061-5094 (Online) |
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