Staged Angioplasty for Carotid Artery Stenosis to Prevent Postoperative Hyperperfusion

Yoshimura, Shinichi; Kitajima, Hideomi; Enomoto, Yukiko; Yamada, Kiyofumi; Iwama, Toru

doi:10.1227/01.neu.0000334046.41985.bb

Cited by 59 publications

(67 citation statements)

References 23 publications

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“…6) SPECT was performed immediately following stenting, and no hyperperfusion was revealed. However, blood pressure was strictly controlled both during and after the procedure.…”

Section: Case Reportmentioning

confidence: 99%

Angioplasty and Stenting of Totally Occluded Common Carotid Artery at the Chronic Stage -Case Report-

Takagi

Yoshimura

Yamada

et al. 2010

Neurol. Med. Chir.(Tokyo)

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“…6) SPECT was performed immediately following stenting, and no hyperperfusion was revealed. However, blood pressure was strictly controlled both during and after the procedure.…”

Section: Case Reportmentioning

confidence: 99%

Angioplasty and Stenting of Totally Occluded Common Carotid Artery at the Chronic Stage -Case Report-

Takagi

Yoshimura

Yamada

et al. 2010

Neurol. Med. Chir.(Tokyo)

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“…However, they may have been too large to prevent hyperperfusion. Yoshimura et al 8,10) targeted a vascular lumen diameter of ≥2 mm using PTA balloons measuring 2.5 to 3 mm in diameter. In the future, initial treatment with a balloon measuring 3 mm in diameter should be considered when encountering similar patients.…”

Section: Casementioning

confidence: 99%

“…On the other hand, one-stage stenting should be performed when sufficient vasodilation is not achieved by PTA alone or when restenosis/reocclusion, a residual thrombus, or vascular dissociation is present. 8,10) In Case 1, a red thrombus measuring 2 cm was retrieved through a stent retriever at the site of cervical ICA occlusion. Before collection, DSA with a microcatheter at the distal occlusion site showed translucency, suggesting a thrombus at the occlusion site; the possibility of embolic occlusion could not be ruled out, and a stent retriever was initially used.…”

Section: Casementioning

confidence: 99%

“…With respect to such two-stage treatment, Fargen et al 2) also recommended similar strategies. Two-stage treatment for stenosis of the cervical ICA was first reported by Yoshimura et al 8) as staged angioplasty to avoid hyperperfusion. For staged angioplasty, DAPT is introduced before initial treatment, but DAPT introduction in the presence of re-or luxury-perfusion may induce hemorrhage when performing emergency CAS for AIS.…”

Section: Casementioning

confidence: 99%

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Staged Angioplasty and Stenting for Severe Cervical Internal Carotid Artery Stenosis in the Setting of Acute Ischemic Stroke

Inoue¹,

Fujita

Mizowaki³

et al. 2017

JNET

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Objective:We report two patients who underwent two-stage angioplasty and carotid artery stenting (CAS) for marked stenosis of the cervical internal carotid artery (ICA) related to acute intracranial artery occlusion.Case Presentations: In Case 1, thrombectomy and angioplasty for cervical ICA occlusion were performed. Although the M2 region of the middle cerebral artery was occluded, thrombectomy led to recanalization. Later, CAS was conducted. In Case 2, angioplasty for stenosis at the ICA origin was performed, leading to recanalization of the main intracranial artery.Later, CAS was conducted. Conclusion:Staged angioplasty may be selected as an option for stenosis of the cervical ICA with acute intracranial artery occlusion.

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“…In 2009, Yoshimura et al 9) reported that the use of staged angioplasty (SAP), which consisted of undersized-balloon angioplasty followed by delayed CAS, was an especially promising method for preventing CHS. 9) However, the penetration rate and efficacy of SAP in patients having a high risk of CHS in real clinical settings have yet to be thoroughly investigated.…”

Section: Introductionmentioning

confidence: 99%

Periprocedural Evaluation and Management against Cerebral Hyperperfusion Syndrome after Carotid Artery Stenting in Japan: A Nationwide Questionnaire Survey

Hayakawa

Matsumaru

Sakai

et al. 2017

NOUSHINKEI KEKKANNAI TIRYOU

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Objective: Cerebral hyperperfusion syndrome (CHS) including intracranial hemorrhage (ICH) is a serious complication after carotid artery stenting (CAS). Therefore, neurointerventionalists in Japan commonly stratify the risk for CHS preprocedurally in CAS candidates using various imaging tests that are available, and sometimes performed preventive methods against CHS, such as staged angioplasty (SAP), undersized-balloon angioplasty followed by delayed CAS. In the current study, we used a nationwide questionnaire survey to clarify the current status of the periprocedural management against CHS and the 30-day outcomes of patients with a high risk of CHS after undergoing CAS or endovascular carotid revascularization procedures, such as SAP or stand-alone angioplasty. This study specifically analyzed the data for the periprocedural management against CHS. Materials and Methods:Between June and August 2014, questionnaires were emailed to all of the neurointerventional specialists certified by the Japanese Society for Neuroendovascular Therapy (JSNET). If two or more specialist physicians belonged to an institute, a representative physician of the institute answered the questionnaire. This study focused on 14 items of the questionnaire that were directed at examining the preprocedural imaging tests done to evaluate the risk of CHS, the periprocedural management strategies used to prevent CHS, and the postprocedural imaging tests to detect hyperperfusion phenomenon, among others.Results: Replies were obtained from 154 institutes which represented 336 JSNET-certified neurointerventional specialists. Preprocedural imaging tests done to evaluate the risk of CHS were performed in 144 institutes (93.5%), with single-photon emission CT (SPECT) the most used modality in 88.2% of the institutes. Acetazolamide challenge was performed in 114 (89.8%) of 127 institutes that used preprocedural SPECT evaluation. Of the institutes performing preprocedural CHS-risk evaluation, general anesthesia was administered during the procedure in 44.4%, periprocedural

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Staged Angioplasty for Carotid Artery Stenosis to Prevent Postoperative Hyperperfusion

Cited by 59 publications

References 23 publications

Angioplasty and Stenting of Totally Occluded Common Carotid Artery at the Chronic Stage -Case Report-

Angioplasty and Stenting of Totally Occluded Common Carotid Artery at the Chronic Stage -Case Report-

Staged Angioplasty and Stenting for Severe Cervical Internal Carotid Artery Stenosis in the Setting of Acute Ischemic Stroke

Periprocedural Evaluation and Management against Cerebral Hyperperfusion Syndrome after Carotid Artery Stenting in Japan: A Nationwide Questionnaire Survey

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