Gerrit J de Borst

Publications (3)7.59 Total impact

• Source

  Available from: J.P. de Vries

  Article: Carotid angioplasty and stenting for postendarterectomy stenosis: long-term follow-up.

  Gerrit J de Borst, Rob G A Ackerstaff, Jean-Paul P M de Vries, Erik D vd Pavoordt, Jan Albert Vos, Tim T Overtoom, Frans L Moll
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  ABSTRACT: Carotid angioplasty and stenting (CAS) for recurrent stenosis after carotid endarterectomy (CEA) has been proposed as an alternative to redo CEA. Although early results are encouraging, the extended durability remains unknown. We present the long-term surveillance results of CAS for post-CEA restenosis. Between 1998 and 2004, 57 CAS procedures were performed in 55 patients (36 men) with a mean age of 70 years. The mean interval between CEA and CAS was 83 months (range, 6 to 245). Nine patients (16%) were symptomatic. CAS was performed successfully in all patients. No deaths or strokes occurred. A periprocedural transient ischemic attack (TIA) occurred in two patients. During a mean follow-up of 36 months (range, 12 to 72 months), two patients exhibited ipsilateral cerebral symptoms (1 TIA, 1 minor stroke). In 11 patients (19%), in-stent restenosis (> or =50%) was detected post-CAS at month 3 (n = 3), 12 (n = 3), 24 (n = 2), 36 (n = 1), 48 (n = 1), and 60 (n = 1). The cumulative rates of in-stent restenosis-free survival at 1, 2, 3, and 4 years were 93%, 85%, 82%, and 76%, respectively. Redo procedures were performed in six patients, three each received repeat angioplasty and repeat CEA with stent removal. The cumulative rates of freedom from reintervention at 1, 2, 3, and 4 years were 96%, 94%, 90%, and 84%, respectively. Carotid angioplasty and stenting for recurrent stenosis after CEA can be performed with a low incidence of periprocedural complications with durable protection from stroke. The rate of in-stent recurrent stenosis is high, however, and does not only occur early after CAS but is an ongoing process.
  Journal of Vascular Surgery 02/2007; 45(1):118-23. · 3.21 Impact Factor
• Article: Bilateral traumatic carotid artery dissection in a child.

  Gerrit J de Borst, Martijn G Slieker, Louisa M Monteiro, Frans L Moll, Kees P J Braun
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  ABSTRACT: Traumatic dissection of the carotid artery is an infrequent but serious complication of blunt craniocervical injury. There is controversy regarding the need for diagnostic screening and management. This report presents a child with delayed neurologic symptoms and multiple cerebral infarcts secondary to bilateral extracranial traumatic carotid artery dissection. The pathophysiology, clinical presentation, and treatment options of blunt carotid artery trauma are discussed.
  Pediatric Neurology 06/2006; 34(5):408-11. · 1.52 Impact Factor
• Article: A percutaneous approach to deep venous valve insufficiency with a new self-expanding venous frame valve.

  Gerrit J de Borst, Joep A W Teijink, Marlowe Patterson, Tino C Quijano, Frans L Moll
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  ABSTRACT: To ascertain if a percutaneously delivered venous valve bioprosthesis (PVVB) can be implanted in the porcine venous system and function without complications. The PVVB is a glutaraldehyde-preserved, valve-bearing venous xenograft sutured inside a memory-coded nitinol frame (diameter 10, 12, or 14 mm). In 10 50-kg pigs, the external jugular vein was exposed, and a 16-F introducer sheath was positioned in the common iliac vein. One PVVB was inserted and deployed in each iliac vein under fluoroscopic control. After PVVB implantation, all animals were randomly given either vitamin K antagonists (1-2 mg/d) (group I) or a combination of aspirin (150 mg/d) and clopidogrel (75 mg/d) (group II), which were shown in a preliminary pilot study to be the most effective anticoagulation regimens in the pig model. Ascending and descending completion phlebograms were performed. PVVBs were evaluated with phlebography at 4 weeks to assess patency and competence; all PVVBs were explanted and processed for histological analysis. In 8 animals, the PVVB was successfully deployed in both the left and right iliac veins. In 2 pigs, only 1 PVVB was inserted due to vascular anomalies. Completion phlebography demonstrated 18 patent and competent valves. At 2 weeks, bleeding complications occurred in 3 group I pigs; all 5 animals were terminated to prevent further complications. Of the 8 valves in this group, 7 were patent (3 competent) by phlebography; 1 PVVB had migrated due to known undersizing of the stent frame. At 4 weeks, group II (5 pigs, 10 valves) analysis revealed 5 patent (3 competent) valves; no bleeding complications occurred in this group. Histology showed thrombosis as the cause of occlusion in all 5 non-patent valves from group II. Deployment of a glutaraldehyde-fixed bovine vein sutured to a self-expanding nitinol stent in the porcine iliac vein is technically feasible. Development of a venous bioprosthesis that can be placed percutaneously may have important clinical applications as an endovascular treatment for chronic venous insufficiency when it is due to valvular incompetence.
  Journal of Endovascular Therapy 05/2003; 10(2):341-9. · 2.86 Impact Factor