Successful Treatment of Symptomatic Intracranial Carotid Artery Stenosis Using a 24-mm Long Bare Metal Coronary Stent

Rehman, Azeem A.; Turner, Ryan C.; Lucke‐Wold, Brandon; Boo, SoHyun

doi:10.1016/j.wneu.2017.04.018

Cited by 4 publications

(3 citation statements)

References 26 publications

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“…In all five of our patients, one single stent was implanted, rather than multiple overlapping stents. The use of extra-long stents in the internal carotid artery has been reported in the literature (Rehman et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

Willis Covered Stent Implantation for Treating Radiation Internal Carotid Blowout Syndrome in Nasopharyngeal Carcinoma

Nie¹,

Wu²,

Yi³

et al. 2022

FMCR

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Purpose: The study of Willis covered stent implantation on life-threatening hemorrhage from Radiation Internal Carotid Blowout Syndrome (RICBS) in patients with Nasopharyngeal Cancer (NPC) was evaluated in our hospital. Materials and Methods: Five NPC patients (3 male and 2 female patients) received Willis covered stent implantation from April 2011 to March 2017, in which radiation induced hemorrhage occurred in Internal Carotid Artery (ICA) was included in this study. The median age in the patient cohort was 56 (47-63). All patients were previously treated with radiotherapy (4 received IMRT and 1receivedheavy-ion RT). The median time was four years before the ICA ruptures after irradiation. The RICBS involved the C2 segment of the ICA in three patients and C3 in two patients. Results: All five patients’ ICA bleeding stopped immediately after the operation of Willis covered stent implantation. Follow-up mean time is 10 months. One patient died of suffocation (nasal hematorrhea) 2 weeks after the operation, in which the skull base is involved from recurrent lesions and associated dysphagia. One patient had rehaemorrhagia a week after the operation. One patient died of other accident 15 months after the operation. No adverse effects such as stroke and ischemia were found in all five patients during the follow-up period. Conclusion: The Willis covered stent implantation can immediately stop the bleeding caused by RICBS to save lives immediately. It is an effective and practical method to treat RICBS in NPC patients or other head and neck cancers patients, especially for the radiation-induced vascular events

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Section: Discussionmentioning

confidence: 99%

Willis Covered Stent Implantation for Treating Radiation Internal Carotid Blowout Syndrome in Nasopharyngeal Carcinoma

Nie¹,

Wu²,

Yi³

et al. 2022

FMCR

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“…In conventional treatments, carotid endarterectomy (CEA) and carotid artery stenting (CAS) have been pivotal in short-segment (<2–2.5 cm) pathologies of the ICA, which depend on atherosclerotic processes [ 5 , 6 ]. Randomized trials have established the efficacy of CEA in significantly reducing the 5-year risk of stroke in patients with symptomatic and asymptomatic stenoses [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Adventitia Layer-Focused Microsurgical Flow Reconstruction for Long-Segment Tubular Stenosis of the Cervical Segment (C1) Internal Carotid Artery: Clinical Valuable Experience in 20 Cases

Cekic,

Ustun

2024

Brain Sciences

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To evaluate the efficacy of perivascular sympathectomy in managing adventitia layer-related long-segment tubular stenosis of cervical segment (C1) internal carotid arteries (ICAs) in a cohort where conventional medical and endovascular interventions were not viable options, we retrospectively analyzed 20 patients (8 males, 12 females, aged 41–63 years) who underwent perivascular sympathectomy for long-segment (>5 cm) tubular cervical ICA stenosis (non-atherosclerotic, non-intima related, and nondolichoarteriopathic) between 2017 and 2023. The procedure aimed to alleviate symptoms such as hemiparesis, pulsatile tinnitus, and migraines associated with transient ischemic attacks (TIAs). Preoperative and postoperative symptoms were assessed, and patient follow-up was conducted by MR angiography and perfusion studies. Postoperatively, 10 out of 11 migraine sufferers (90.9%) reported complete cessation of symptoms, while one patient (9.09%) experienced reduction in frequency and intensity. In cases of tinnitus, six out of nine patients (66.6%) reported complete resolution, two (22.2%) had reduced symptoms, and one (11.1%) saw no change. Regarding motor function, all 12 patients (100%) with initial hemiparesis (30–40% loss of motor function) showed complete recovery postoperatively. There was no TIA attack among the patients after the procedure in the mean two-year follow-up. Perivascular sympathectomy has shown promising results in alleviating symptoms and preventing recurrent cerebrovascular events in long-segment tubular stenosis of cervical ICAs.

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“…It principally involves the brain tissue supplied by the VBA system (posterior circulation), including the brain stem, cerebellum, and part of the temporal lobe. Accounting for approximately 20-25% of all ischemic strokes, posterior circulation ischemic stroke carries a mortality rate of approximately 30% (3), and is mainly caused by vertebral artery stenosis or hypoplasia. Patients with a vertebral artery diameter (VAD) of ≤2.5 mm are evaluated as simple vertebral artery hypoplasia (VAH) or coexisting intracranial stenosis.…”

Section: Introductionmentioning

confidence: 99%

Feasibility of evaluating the stenosis of intracranial segment in the vertebral artery using neck-brain integrated ultrasound: a comparison with computed tomography angiography and digital subtraction angiography

Wang¹,

Ma²,

Yang³

et al. 2020

Ann Transl Med

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Background: Currently, no clear diagnostic indicator of vertebral artery hypoplasia (VAH) or intracranial stenosis exists in clinic. This study aims to study the feasibility of neck-brain integrated ultrasound for evaluating stenosis of the intracranial segment in the vertebral artery by comparing with those of computed tomography angiography (CTA) and digital subtraction angiography (DSA). Methods: Clinical data of 138 patients who presented to our hospital with dizziness and headache as the main symptoms between April 2018 and June 2019 were retrospectively analyzed. Patients were divided into observation group and unilateral VAH group. The diagnosing accuracy of ultrasound, CTA, and DAS, the vertebral artery diameter (VAD), blood flow, end diastolic velocity (EDV), peak systolic velocity (PSV) values, resistance indexes (RIs), and difference of RI were compared between the two groups. The sensitivity, specificity and accuracy of ultrasound hemodynamic indicators in assessing stenosis of the intracranial segment of the vertebral artery were calculated.Results: The accuracy rates of mild stenosis and non-stenosis with neck-brain integrated ultrasound were significantly different from those with CTA and DSA examination (P<0.05). The VAD, blood flow, EDV and PSV values of the affected side in the observation group were lower than those of the VAH side in the unilateral VAH group, while the RI and RI difference value were significantly higher than the unilateral VAH group (P<0.05). When the predicted boundary value was 2.084 mm (VAD), 56.41 mL/min (blood flow), 8.47 cm/s (EDV), 0.743 (RI), and 0.149 (difference of RI), the sensitivity and specificity were (86.43%, 49.45%), (88.67%, 47.42%), (80.47%, 68.71%), (82.71%, 84.66%), and (95.84%, 80.11%), respectively.Conclusions: Neck-brain integrated ultrasound is of great value as a noninvasive examination in the diagnosis of stenotic lesions of the internal cervical vertebral artery. VAD, EDV, blood flow, RI, and the difference in RI can be used as indicators to evaluate stenosis of the internal carotid segment of the vertebral artery and provide a reliable basis for the clinical diagnosis of posterior circulation ischemia.

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Successful Treatment of Symptomatic Intracranial Carotid Artery Stenosis Using a 24-mm Long Bare Metal Coronary Stent

Cited by 4 publications

References 26 publications

Willis Covered Stent Implantation for Treating Radiation Internal Carotid Blowout Syndrome in Nasopharyngeal Carcinoma

Willis Covered Stent Implantation for Treating Radiation Internal Carotid Blowout Syndrome in Nasopharyngeal Carcinoma

Adventitia Layer-Focused Microsurgical Flow Reconstruction for Long-Segment Tubular Stenosis of the Cervical Segment (C1) Internal Carotid Artery: Clinical Valuable Experience in 20 Cases

Feasibility of evaluating the stenosis of intracranial segment in the vertebral artery using neck-brain integrated ultrasound: a comparison with computed tomography angiography and digital subtraction angiography

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