We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Cerebral Intolerance During Flow Arrested Carotid Angioplasty.
- Authors
Louis, Myron St.; Park, Brian D.; Dahn, Michael; Bozeman, Patricia
- Abstract
Introduction: The use of flow arrest as a means of providing cerebral protection during carotid angioplasty offers the advantages of improved efficiency of debris removal and the ability to provide protection under unfavorable (tortuous) anatomic circumstances. However, in contrast to the filtration methods of cerebral protection, this modality requires complete interruption of antegrade carotid artery flow during balloon angioplasty and stent deployment. Methods: We report our experience with 9 patients undergoing carotid angioplasty with the Mo.Ma device, which utilizes common and external carotid artery balloon occlusion during the angioplasty procedure. We assessed the clinical outcomes and intraprocedural hemodynamic data. Results: The average duration of carotid occlusion was 8.3 minutes. Of the 9 patients, 2 patients (22%) experienced cerebral intolerance. No stroke occurred in this patient cohort. There appeared to be a poor relationship between procedure intolerance and the presence of significant contralateral stenosis or low carotid back pressure. Furthermore, the incidence of postangioplasty hypotension was not clearly related to cerebral intolerance. Conclusion: Carotid angioplasty with stenting can be safely conducted with flow arrest as an alternative to filter-type cerebral protection devices. However, because cerebral intolerance is not an infrequent occurrence with this approach, clinicians must be cognizant of management strategies for transient cerebral intolerance.
- Subjects
CEREBRAL ischemia; CAROTID artery stenosis; CAROTID artery; CEREBRAL circulation; SEIZURES (Medicine); HEMIPLEGIA; HEALTH outcome assessment; SPASMS; SURGICAL stents; TRANSLUMINAL angioplasty; TREATMENT effectiveness; DESCRIPTIVE statistics; EQUIPMENT &; supplies; PREVENTION; THERAPEUTICS
- Publication
Vascular & Endovascular Surgery, 2012, Vol 46, Issue 1, p85
- ISSN
1538-5744
- Publication type
Article
- DOI
10.1177/1538574411422117