nach oben

Clinical Neuroradiology

Erschienen in:

25.10.2016 | Original Article

Endovascular Treatment for Near Occlusion of the Internal Carotid Artery

30-Day Outcome and Long-Term Follow-Up

Erschienen in: Clinical Neuroradiology | Ausgabe 2/2018

Einloggen, um Zugang zu erhalten

Abstract

Background

The treatment strategy and the correct incidence of near occlusion (NO) of the internal carotid artery (ICA) is still controversial. In routine radiological imaging NO can easily be misdiagnosed as complete occlusion and there is no consensus on the standard treatment strategy.

Purpose

To present our perioperative and long-term follow-up results of ICA NO patients treated with carotid artery stenting (CAS).

Material and Methods

Between 2004–2014 a total of 182 patients with ICA NO were evaluated for CAS. The study included 132 male (72.5 %) and 50 female (27.5 %) patients with a mean age of 70.2 years. Patients underwent a clinical neurological evaluation and radiological imaging of the carotid arteries before the CAS procedure. Of the patients 80 (44 %) were asymptomatic. The median clinical and carotid Doppler ultrasound (DUS) follow-up period was 64 months (range 18–124 months).

Results

In 182 patients CAS were performed, 4 patients (2.2 %) developed minor stroke, 2 patients (1.1 %) developed myocardial infarction but no major stroke or death occurred in the following 30-day period. Asymptomatic restenosis was detected in seven patients (3.8 %) in the follow-up period.

Conclusion

With sufficient neurological evaluation during pretreatment and posttreatment periods and when the procedure is performed with technologically developed products by an experienced interventional team, CAS is beneficial in patients with ICA NO.

Mehigan JT, Olcott C 4th. The carotid “string” sign. Differential diagnosis and management. Am J Surg. 1980;140:137–43.CrossRefPubMed

Fox AJ, Eliasziw M, Rothwell PM, Schmidt MH, Warlow CP, Barnett HJ. Identification, prognosis, and management of patients with carotid artery near occlusion. AJNR Am J Neuroradiol. 2005;26:2086–94.PubMed

Johansson E, Fox AJ. Carotid Near-Occlusion: A Comprehensive Review, Part 1--Definition, Terminology, and Diagnosis. AJNR Am J Neuroradiol. 2016;37(1):2–10.CrossRefPubMed

Johansson E, Fox AJ. Carotid Near-Occlusion: A Comprehensive Review, Part 2--Prognosis and Treatment, Pathophysiology, Confusions, and Areas for Improvement. AJNR Am J Neuroradiol. 2016;37(2):200–4.CrossRefPubMed

North American Symptomatic Carotid Endarterectomy Trial Collaborators. Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. N Engl J Med. 1991;325:445–53.CrossRef

Randomised trial of endarterectomy for recently symptomatic carotid stenosis: final results of the MRC European Carotid Surgery Trial (ECST). Lancet. 1998;35:1379–87.

Rothwell PM, Gutnikov SA, Warlow CP, European Carotid Surgery Trialist’s Collaboration. Reanalysis of the final results of the European Carotid Surgery Trial. Stroke. 2003;34:514–23.CrossRefPubMed

Henderson RD, Eliasziw M, Fox AJ, Rothwell PM, Barnett HJ. Angiographically defined collateral circulation and risk of stroke in patients with severe carotid artery stenosis. Stroke. 2000;31:128–32.CrossRefPubMed

Morgenstern LB, Fox AJ, Sharpe BL, Eliasziw M, Barnett HJ, Grotta JC. The risks and benefits of carotid endarterectomy in patients with near occlusion of the carotid artery. Neurology. 1997;48:911–5.CrossRefPubMed

10.

Rothwell PM, Warlow CP. Low risk of ischemic stroke in patients with reduced internal carotid artery lumen diameter distal to severe symptomatic carotid stenosis: cerebral protection due to low poststenotic flow? On behalf of the European Carotid Surgery Trialists’ Collaborative Group. Stroke. 2000;31:622–30.CrossRefPubMed

11.

Blaser T, Hofmann K, Buerger T, Effenberger O, Wallesch CW, Goertler M. Risk of stroke, transient ischemic attack, and vessel occlusion before endarterectomy in patients with symptomatic severe carotid stenosis. Stroke. 2002;33:1057–62.CrossRefPubMed

12.

O’Leary DH, Mattle H, Potter JE. Atheromatous pseudo-occlusion of the internal carotid artery. Stroke. 1989;20:1168–73.CrossRefPubMed

13.

Ringelstein EB, Berg-Dammer E, Zeumer H. The so-called atheromatous pseudoocclusion of the internal carotid artery. A diagnostic and therapeutical challenge. Neuroradiology. 1983;25:147–55.CrossRefPubMed

14.

Fredericks RK, Thomas TD, Lefkowitz DS, Troost BT. Implications of the angiographic string sign in carotid atherosclerosis. Stroke. 1990;21:476–9.CrossRefPubMed

15.

Kniemeyer HW, Aulich A, Schlachetzki F, Steinmetz H, Sandmann W. Pseudo- and segmental occlusion of the internal carotid artery: A new classification, surgical treatment and results. Eur J Vasc Endovasc Surg. 1996;12:310–20.CrossRefPubMed

16.

Yadav JS, Wholey MH, Kuntz RE, Fayad P, Katzen BT, Mishkel GJ, Bajwa TK, Whitlow P, Strickman NE, Jaff MR, Popma JJ, Snead DB, Cutlip DE, Firth BG, Ouriel K; Stenting and Angioplasty with Protection in Patients at High Risk for Endarterectomy Investigators. Protected carotid-artery stenting versus endarterectomy in high-risk patients. N Engl J Med. 2004;351:1493–501.CrossRefPubMed

17.

Mas JL, Chatellier G, Beyssen B, Branchereau A, Moulin T, Becquemin JP, Larrue V, Lièvre M, Leys D, Bonneville JF, Watelet J, Pruvo JP, Albucher JF, Viguier A, Piquet P, Garnier P, Viader F, Touzé E, Giroud M, Hosseini H, Pillet JC, Favrole P, Neau JP, Ducrocq X; EVA-3S Investigators. Endarterectomy versus stenting in patients with symptomatic severe carotid stenosis. N Engl J Med. 2006;355:1660–71.CrossRefPubMed

18.

Endovascular versus surgical treatment in patients with carotid stenosis in the Carotid and Vertebral Artery Transluminal Angioplasty Study (CAVATAS): a randomised trial. Lancet. 2001;357:1729–37.CrossRef

19.

SPACE Collaborative Group, Ringleb PA, Allenberg J, Brückmann H, Eckstein HH, Fraedrich G, Hartmann M, Hennerici M, Jansen O, Klein G, Kunze A, Marx P, Niederkorn K, Schmiedt W, Solymosi L, Stingele R, Zeumer H, Hacke W. 30 day results from the SPACE trial of stent-protected angioplasty versus carotid endarterectomy in symptomatic patients: a randomised non-inferiority trial. Lancet. 2006;368:1239–47.CrossRefPubMed

20.

International Carotid Stenting Study investigators, Ederle J, Dobson J, Featherstone RL, Bonati LH, van der Worp HB, de Borst GJ, Lo TH, Gaines P, Dorman PJ, Macdonald S, Lyrer PA, Hendriks JM, McCollum C, Nederkoorn PJ, Brown MM. Carotid artery stenting compared with endarterectomy in patients with symptomatic carotid stenosis (International Carotid Stenting Study): an interim analysis of a randomised controlled trial. Lancet. 2010;375:985–97.CrossRefPubMed

21.

Brott TG, Hobson RW 2nd, Howard G, Roubin GS, Clark WM, Brooks W, Mackey A, Hill MD, Leimgruber PP, Sheffet AJ, Howard VJ, Moore WS, Voeks JH, Hopkins LN, Cutlip DE, Cohen DJ, Popma JJ, Ferguson RD, Cohen SN, Blackshear JL, Silver FL, Mohr JP, Lal BK, Meschia JF; CREST Investigators. Stenting versus endarterectomy for treatment of carotid-artery stenosis. N Engl J Med. 2010;363:11–23. Erratum in: N Engl J Med. 2010;363(2):198. N Engl J Med. 2010;363(5):498.CrossRefPubMedPubMedCentral

22.

Bartlett ES, Walters TD, Symons SP, Fox AJ. Diagnosing carotid stenosis near-occlusion by using CT angiography. AJNR Am J Neuroradiol. 2006;27:632–7.PubMed

23.

Weber J, Veith P, Jung B, Ihorst G, Moske-Eick O, Meckel S, Urbach H, Taschner CA. MR angiography at 3 Tesla to assess proximal internal carotid artery stenosis: contrast-enhanced or 3D time-of-flight MR angiography? Clin Neuroradiol. 2015;25(1):41–8.CrossRefPubMed

24.

Gabrielsen TO, Seeger JF, Knake JE, Burke DP, Stilwill EW. The nearly occluded internal carotid artery: a diagnostic trap. Radiology. 1981;138:611–8.CrossRefPubMed

25.

Paciaroni M, Eliasziw M, Sharpe BL, Kappelle LJ, Chaturvedi S, Meldrum H, Barnett HJ. Clinical and angiographic outcomes in symptomatic patients with 70 % to 99 % carotid artery stenosis. Stroke. 2000;31:2037–42.CrossRefPubMed

26.

Perler BA, Burdick JF, Williams GM. Progression to total occlusion is an under recognized complication of the medical management of carotid disease. J Vasc Surg. 1991;14:821–6.CrossRefPubMed

27.

Sekhar LN, Heros RC, Lotz PR, Rosenbaum AE. Atheromatous pseudo-occlusion of the internal carotid artery. J Neurosurg. 1980;52:782–9.CrossRefPubMed

28.

Berman SS, Bernhard VM, Erly WK, McIntyre KE, Erdoes LS, Hunter GC. Critical carotid artery stenosis: diagnosis, timing of surgery, and outcome. J Vasc Surg. 1994;20:499–508.CrossRefPubMed

29.

Greiner C, Wassmann H, Palkovic S, Gauss C. Revascularization procedures in internal carotid artery pseudo-occlusion. Acta Neurochir (Wien). 2004;146:237–43.CrossRef

30.

Cremonesi A, Manetti R, Setacci F, Setacci C, Castriota F. Protected carotid stenting: clinical advantages and complications of embolic protection devices in 442 consecutive patients. Stroke. 2003;34:1936–41.CrossRefPubMed

31.

Jansen O, Fiehler J, Hartmann M, Brückmann H. Protection or non protection in carotid stent angioplasty. The influence of interventional techniques on outcome data from the SPACE trial. Stroke. 2009;40:841–6.CrossRefPubMed

32.

Gurm HS, Yadav JS, Fayad P, Katzen BT, Mishkel GJ, Bajwa TK, Ansel G, Strickman NE, Wang H, Cohen SA, Massaro JM, Cutlip DE; SAPPHIRE Investigators. Long-term results of carotid stenting versus endarterectomy in high-risk patients. N Engl J Med. 2008;358:1572–9.CrossRefPubMed

33.

Mas JL, Trinquart L, Leys D, Albucher JF, Rousseau H, Viguier A, Bossavy JP, Denis B, Piquet P, Garnier P, Viader F, Touzé E, Julia P, Giroud M, Krause D, Hosseini H, Becquemin JP, Hinzelin G, Houdart E, Hénon H, Neau JP, Bracard S, Onnient Y, Padovani R, Chatellier G; EVA-3S investigators. Endarterectomy versus angioplasty in Patients with Symptomatic Severe Carotid stenosis (EVA-3S) trial: results up to 4 years from a randomised, multicenter trial. Lancet Neurol. 2008;7:885–92.CrossRefPubMed

34.

Mantese VA, Timaran CH, Chiu D, Begg RJ, Brott TG; CREST Investigators. The carotid revascularization endarterectomy versus stenting trial (CREST): Stenting versus endarterectomy for treatment of carotid disease. Stroke. 2010;41:31–4.CrossRef

35.

Nallamothu BK, Gurm HS, Ting HH, Goodney PP, Rogers MA, Curtis JP, Dimick JB, Bates ER, Krumholz HM, Birkmeyer JD. Operator experience and carotid stenting outcomes in Medicare beneficiaries. JAMA. 2011;306:1338–43.CrossRefPubMedPubMedCentral

36.

Naylor AR. A surgeon’s view on endarterectomy and stenting in 2011: lest we forget, it’s all about preventing stroke. Cardiovasc Intervent Radiol. 2012;35:225–33.CrossRefPubMed

37.

Calvet D, Mas JL, Algra A, Becquemin JP, Bonati LH, Dobson J, Fraedrich G, Jansen O, Mali WP, Ringleb PA, Chatellier G, Brown MM. Carotid stenting: is there an operator effect? A pooled analysis from the carotid stenting trialists’ collaboration. Stroke. 2014;45:527–32.CrossRefPubMed

38.

Smout J, Macdonald S, Weir G, Stansby G. Carotid artery stenting: relationship between experience and complication rate. Int J Stroke. 2010;5:477–82.CrossRefPubMed

39.

González A, Gil-Peralta A, Mayol A, Gonzalez-Marcos JR, Moniche F, Aguilar M, Gutierrez I. Internal carotid artery stenting in patients with near occlusion: 30-day and long-term outcome. AJNR Am J Neuroradiol. 2011;32:252–8.CrossRefPubMed

40.

Gil-Peralta A, González A, González-Marcos JR, Mayol A, Boza F, Ruano J, Cayuela A. Internal carotid artery stenting in patients with symptomatic atheromatous pseudo-occlusion. Cerebrovasc Dis. 2004;17:105–12.CrossRefPubMed

41.

Terada T, Tsuura M, Matsumoto H, Masuo O, Tsumoto T, Yamaga H, Itakura T. Endovascular treatment for pseudo-occlusion of the internal carotid artery. Neurosurgery. 2006;59:301–9.CrossRefPubMed

42.

Choi BS, Park JW, Shin JE, Lü PH, Kim JK, Kim SJ, Lee DH, Kim JS, Kim HJ, Suh DC. Outcome evaluation of carotid stenting in high-risk patients with symptomatic carotid near occlusion. Interv Neuroradiol. 2010;16:309–16.CrossRefPubMedPubMedCentral

43.

Ruiz-Salmerón RJ, Gamero MA, Carrascosa C, Pérez S, de Araujo D, Marcos F, Rodríguez de Leiras S, Vizcaíno M, Caparrós C, Izquierdo G. Carotid artery stenting: clinical and procedural implications for near-occlusion stenosis. Neurologia. 2013;28:535–42.CrossRefPubMed

44.

Son S, Choi DS, Kim SK, Kang H, Park KJ, Choi NC, Kwon OY, Lim BH. Carotid artery stenting in patients with near occlusion: a single-center experience and comparison with recent studies. Clin Neurol Neurosurg. 2013;115:1976–81.PubMed

45.

Oka F, Ishihara H, Kato S, Oku T, Yamane A, Kunitugu I, Suzuki M. Cerebral hemodynamic benefits after carotid artery stenting in patients with near occlusion. J Vasc Surg. 2013;58:1512–7.CrossRefPubMed

46.

Koutsoumpelis A, Kouvelos G, Peroulis M, Tzilalis V, Matsagkas M. Surgical and endovascular intervention on internal carotid artery near occlusion. Int Angiol. 2015;34:172–81.CrossRefPubMed

Titel: Endovascular Treatment for Near Occlusion of the Internal Carotid Artery
30-Day Outcome and Long-Term Follow-Up
Publikationsdatum: 25.10.2016
Erschienen in: Clinical Neuroradiology / Ausgabe 2/2018
Print ISSN: 1869-1439
Elektronische ISSN: 1869-1447
DOI: https://doi.org/10.1007/s00062-016-0546-8

Neu im Fachgebiet Radiologie

23.04.2024 | Pankreaskarzinom | Nachrichten

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Endovascular Treatment for Near Occlusion of the Internal Carotid Artery

30-Day Outcome and Long-Term Follow-Up

Abstract

Background

Purpose

Material and Methods

Results

Conclusion

Neu im Fachgebiet Radiologie

S3-Leitlinie zu Pankreaskrebs aktualisiert

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

„Nur wer sich gut aufgehoben fühlt, kann auch für Patientensicherheit sorgen“

Wie toxische Männlichkeit der Gesundheit von Männern schadet

Update Radiologie

Springer Medizin

Abstract

Background

Purpose

Material and Methods

Results

Conclusion

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 2/2018

Correlation of CT and Histopathology in Resorption of the Distal Long Process of the Incus

The Medical Informatics Consortia: How Does Neuroradiology Benefit?

Growth of Untreated Unruptured Small-sized Aneurysms (≺7mm): Incidence and Related Factors

Endovascular Thrombectomy in Acute Ischemic Stroke: Outcome in Referred Versus Directly Admitted Patients

Management of Unruptured Saccular Aneurysms of the M1 Segment with Flow Diversion

Regional Differences in Thrombectomy Rates

Neu im Fachgebiet Radiologie

S3-Leitlinie zu Pankreaskrebs aktualisiert

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

„Nur wer sich gut aufgehoben fühlt, kann auch für Patientensicherheit sorgen“

Wie toxische Männlichkeit der Gesundheit von Männern schadet

Update Radiologie