Duplex-assisted carotid artery stenting without administration of contrast medium for patients with chronic kidney disease or allergic reaction

Abstract

Duplex-assisted CAS without administration of contrast medium could be an alternative option in selected patients deemed to be at high risk for renal failure from nephrotoxic contrast medium or who have an allergy to contrast medium.

Mobility of an in-stent plaque protrusion detected with carotid duplex during the carotid artery stenting procedure: a case report

“…In contrast, carotid duplex, which has the benefit of excellent temporal resolution, is suitable for visualizing the mobility of ISP [14]. Therefore, carotid duplex can not only be used as an adjunctive imaging technique for reducing or avoiding the use of a contrast medium [6][7][8] but also can be used to complement IVUS for the characterization of ISPs. Radiation exposure of a sonographer, which seems to be a major concern, can be prevented by stopping fluoroscopic imaging during carotid duplex scanning.…”

“…To date, several studies have reported the usefulness of adjunctive carotid duplex in CAS, particularly in minimizing iodinated contrast usage [6][7][8]. Here, we present the case of a patient with ISP with mobile features, which was detected using extravascular ultrasonography during the procedure of duplex-assisted CAS without the use of a contrast medium.…”

Ultrasonographically‐guided stent placement at the vertebral artery origin without contrast medium: A case report

“…Non-enhanced MRA of the aortic arch and iliac-femoral artery was performed preoperatively to evaluate the access route, as previously reported. 4 First, we performed our previously reported ultrasonographically-guided CAS 4 on the patient's right side, without any complication. MRA confirmed the bilateral severe VAOS, and showed the bilateral absence of (Figure 3A,B) and aspirating the blood (about 100 mL) to remove the debris, the balloon and EPD were retracted under ultrasonographic monitoring.…”

“…Several studies have reported ultrasonographic guidance of carotid artery stenting (CAS) without contrast medium. [3][4][5] However, ultrasonographic imaging of the vertebral artery origin may be difficult because it can be located deep in the chest. Based on our experience with ultrasonographic guidance of CAS, 4 we applied this technique to VAOS stent placement.…”

“…[3][4][5] However, ultrasonographic imaging of the vertebral artery origin may be difficult because it can be located deep in the chest. Based on our experience with ultrasonographic guidance of CAS, 4 we applied this technique to VAOS stent placement. Although stent placement for VAOS assisted with intravascular ultrasound (IVUS) without contrast injection has been reported, 6 we found no report of conventional B-mode ultrasonographic guidance of stent placement for VAOS treatment without contrast medium.…”