Effect of aortic arch type on technical indicators in patients undergoing carotid artery stenting

Abstract

Objective This study was performed to explore the effect of the aortic arch type on technical indicators in patients undergoing carotid artery stenting (CAS). Methods The data of 224 consecutive patients who underwent unilateral CAS from January 2011 to December 2012 were retrospectively analyzed. The requirement for placement of the guiding catheter into the common carotid artery with assistance of an angiographic catheter, fluoroscopy time, contrast agent dose, and adverse events were recorded. Results The fluoroscopy time was significantly longer and the contrast agent dose was significantly higher in patients with Type III than Type I and II arches. Significantly more patients with Type III than Type I and II arches required placement of the guiding catheter with assistance of an angiographic catheter (46.2% vs. 15.0%, respectively). The procedural success rate was significantly lower in patients with Type III than Type I and II arches (96.2% vs. 100.0%, respectively). The incidence of death, myocardial infarction, and all types of stroke was significantly higher in patients with Type III than Type I and II arches (7.7% vs. 1.7%, respectively). Conclusions The aortic arch type is an important influential factor in CAS. Type III arches are associated with more difficulties and complications.

Evolut Self-Expanding Transcatheter Aortic Valve Replacement in Patients with Extremely Horizontal Aorta (Aortic Root Angle ≥ 70°)

“…To appropriately determine the viability of left TAx TAVR, preprocedural CT assessment of the aortic arch should be used to confirm the angulation and position of the takeoff of the left subclavian artery from the aortic arch. 24,25) In type I aortic arch where the origin of all three major arteries are located in the same horizontal plane as the greater curvature of the aortic arch, the stiff wire and the delivery catheter can be efficiently advanced along the greater curvature of the ascending aorta. In this respect, the left TAx access should be selected preferentially since it closely mimics TF access.…”

The Benefits can be Achieved after the Shift from Transfemoral Access to Transradial Access in Cerebral Angiography

“…In this study, the TRA learning curve was overcome after performing 30 cases, which was the same as for TFA, because the operator was relatively experienced in TRA. Shen et al also found that TFA might be time-consuming in patients with type III and bovine aortic arch [25]. In the present study, for both TFA and TRA, the operator became skilled after performing 30 angiograms.…”

Anatomical Considerations for Endovascular Intervention for Extracranial Carotid Disease: A Review of the Literature and Recommended Guidelines

“…We conducted a systematic literature review without meta-analysis per Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines [8]. Nineteen studies were identified that discussed perioperative risk in the context of relevant anatomy [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] (Table 1) in addition to fourteen studies [28][29][30][31][32][33][34][35][36][37][38][39][40][41] (Table 2) and fifteen case reports/series [42][43][44][45][46][47][48][49][50][51][52][53][54]…”