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ABSTRACT: The aim of this study was to evaluate the feasibility and safety of the transfacial venous embolization of cavernous or paracavernous dural arteriovenous fistula (DAVF) in which approach via inferior petrosal sinus (IPS) was not feasible.
We identified the cases of transfacial venous embolization of cavernous sinus (CS) or adjacent dural sinuses from the neurointerventional database of three hospitals. The causes and clinical and angiographic outcomes of transfacial venous embolization were retrospectively evaluated.
Twelve patients with CS (n = 11) or lesser wing of sphenoid sinus (LWSS, n = 1) DAVF were attempted to treat by transvenous embolization via ipsilateral (n = 10) or contralateral (n = 2) facial vein. Trans-IPS access to the target lesion was impossible due to chronic occlusion (n = 11) or acute angulation adjacent the target lesion (n = 1). In all twelve cases, it was possible to navigate through facial vein, angular vein, superior ophthalmic vein, and then CS. It was also possible to further navigation to contralateral CS through intercavernous sinus in two cases, and laterally into LWSS in one case. Post-treatment control angiography revealed complete occlusion of the DAVF in eleven cases and partial occlusion in one patient, resulting in complete resolution of presenting symptom in eight and gradually clinical improvement in four patients. There was no treatment-related complication during or after the procedure.
In the cavernous or paracavernous DAVF in which trans-IPS approach is not feasible, the facial vein seems to be safe and effective alternative route for transvenous embolization.
Neurointervention. 02/2013; 8(1):15-22.
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Yong Sam Shin,
Byung Moon Kim,
Sang Hyun Suh,
Pyoung Jeon,
Dong Joon Kim,
Dong Ik Kim,
Bum Soo Kim,
Keon Ha Kim,
Ji Hoe Heo M D,
Hyo Suk Nam,
Young Dae Kim
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ABSTRACT: BACKGROUND:: Intracranial atherosclerotic stenosis (ICAS) is responsible for 9-37% of ischemic strokes. OBJECTIVE:: To evaluate the clinical outcome and risk factors for in-stent restenosis (ISR) after treatment of ICAS with a Wingspan stent. METHODS:: Seventy-seven patients with 79 total target ICAS > 60% (mean, 79.9 ± 8.4%; symptomatic ICAS, 96.2%) underwent attempted treatment with Wingspan stenting between March 2010 and March 2011. A retrospective review of the prospectively registered data was conducted to assess the risk factors for ISR as well as the clinical outcomes of these patients. RESULTS:: The 30-day TIA/stroke and death rates were 5.3% (95% CI, 0.1% to 10.5%) and 0%, respectively. All patients but one were followed clinically for a mean of 18.9 months (range, 12-23 months). During the period, cumulative TIA/stroke and death rates were 8.1% (95% CI, 1.7% to 14.5%) and 0%, respectively. Only one patient suffered a disabling stroke (subarachnoid hemorrhage), which was associated with retreatment of an ISR using a drug-eluting balloon-expandable stent. Follow-up angiography was available in 69 treated vessels (89.6%) at 3-24 months (median: 12 months). Binary ISR rate was 24.6%, of which 17.6% (3 of 17 cases) were symptomatic. Rapid balloon inflation (95% CI, 5.490 to 530.817) and longer length of stenosis (95% CI, 1.093 to 1.891) were independent risk factors for ISR. CONCLUSION:: Wingspan stenting may be effective for appropriately selected ICAS patients. Rapid balloon inflation and longer lengths of stenosis were independent risk factors for ISR.
Neurosurgery 12/2012; · 2.79 Impact Factor
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ABSTRACT: BACKGROUND: Despite accumulated experience and improved understanding of the tools, endovascular treatment of intracranial aneurysms continues to have risks linked to the technique itself, and induces procedure-related complications. The purpose of this study was to report our series of stent salvage using the Enterprise stent for procedure-related complication during coil embolization in patients with ruptured intracranial aneurysms. METHODS: Parent artery thrombosis, parent artery dissection, and coil protrusion were considered to be the procedure-related complications. There were 18 consecutive cases (3 unruptured and 15 ruptured aneurysms) with procedure-related complications rescued by the Enterprise stent from December 2008 to December 2011. Follow-up angiography was performed in 14 of the 15 patients with ruptured aneurysms between 6 and 30 months (mean 14.6 months) after the procedure. RESULTS: The procedure-related complications were parent artery dissection (n = 1), parent artery thrombosis (n = 4), and coil protrusion (n = 10). There was no complication related to delivering or deploying of the Enterprise stent. Initial radiographic results showed 8 cases of complete occlusion and 7 cases of neck remnant. There was no change in the angiographic results during the follow-up periods. CONCLUSIONS: Facing with procedure-related complications during coil embolization of ruptured intracranial aneurysms, the closed-cell designed Enterprise stent might be a useful option for the salvage technique by restoring blood flow and minimizing thromboembolic events.
Acta Neurochirurgica 11/2012; · 1.52 Impact Factor
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ABSTRACT: The authors present a case of isolated dural arteriovenous fistula (DAVF) in the transverse sinus, which developed six years after microvascular decompression caused by hemifacial spasm via suboccipital craniectomy. The lesion was successfully treated by transarterial embolization using Onyx. We reviewed the related radiologic and therapeutic features of DAVF involving an isolated sinus and described the feasibility of the use of Onyx.
Journal of Korean Neurosurgical Society 11/2012; 52(5):480-3. · 0.60 Impact Factor
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ABSTRACT: Intracranial stenting for stent-assisted coiling of aneurysms requires adequate follow-up imaging. The aim of this in vitro study was to compare in-stent artificial luminal narrowing on contrast-enhanced MR angiograms (CE-MRA) when applying Neuroform® and Enterprise® stents for stent-assisted coiling.
Two intracranial nitinol stents (Enterprise® and Neuroform®) were placed in silicon tubes and then imaged at 3 T and 1.5 T by the use of a T1-weighted three-dimensional spoiled gradient-echo sequence with minimal TR and TE. CE-MRAs were obtained by using different imaging planes, voxel sizes, and bandwidths, and with or without parallel imaging. Artificial lumen narrowing (ALN) was calculated and the results were compared.
Lower magnetic field strength, axial plane perpendicular to axis of stent, and wider bandwidth resulted in a lower ALN on CE-MRA for both stents. Larger voxel size resulted in lower ALN for Neuroform® stent. The parallel imaging acceleration factor did not affect ALN. The mean ALN was lower for Neuroform®, but it was not significant by a paired t test.
CE-MRA of the stented lumen of vascular phantom was partially impaired with ALN. Consequently, image plane orientation, magnetic field strength, bandwidth, and voxel size should be adjusted appropriately to reduce ALN.
Korean journal of radiology: official journal of the Korean Radiological Society 09/2012; 13(5):550-6. · 1.32 Impact Factor
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ABSTRACT: Pulsatile tinnitus is tinnitus that coincides with the patient's heartbeat. It constitutes a small portion of all tinnitus, but it is often the first or sole manifestation of a serious disease in the nervous system. Aneurysm of the internal carotid artery is known as a rare cause of pulsatile tinnitus and, in the main, aneurysms of the petrous portion have been reported as a cause of pulsatile tinnitus. We present an interesting case of pulsatile tinnitus that was caused by a paraclinoid aneurysm in this report and discuss clinical features and treatment of paraclinoid aneurysm.
Clinical and Experimental Otorhinolaryngology 09/2012; 5(3):170-2. · 0.92 Impact Factor
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ABSTRACT: The purpose of this study was to investigate the frequency and risk factors of procedure-related thromboembolism on diffusion-weighted imaging (DWI) associated with aneurysmal coil embolization.
We prospectively evaluated 39 consecutive patients with a cerebral aneurysm with DWI after coil embolization. All hyperintense lesions on DWI with a drop of apparent diffusion coefficient values were classified into acute thromboembolic infarction (larger than 5 mm in maximal diameters, and located in the vascular territory of the parent artery) and silent microembolism (single or multiple tiny dot-like lesion, less than 5 mm, usually 1-2 mm in size). Possible risk factors for thromboembolic events included vascular risk factors, aneurysmal factors, and procedure-related factors.
Hyperintense lesions on DWI were seen in 17 (43.6%) patients and symptomatic DWI positive lesions were four (10.3%). Acute thromboembolic infarction was observed in seven (17.9%) patients and silent microembolism in 14 (35.9%) patients. Numbers of silent microembolism ranged from 1 to 15 (mean: 2.86, standard deviation: 3.74). Silent microembolisms were located at ipsilateral (n=3, 21.4%), contralateral (n=5, 35.7%), bilateral (n=4, 28.6%), and not related (n=2, 14.3%) to the procedure site. There were no statistical significant risk factors in acute thromboembolic infarction. However, incidence of silent microembolisms was significantly correlated with left side approach (odds ratio, 4.44, 95% confidence interval, 1.08-18.36; P=0.03).
Left side approach may have increased the likelihood of asymptomatic multiple scattered microemboli after aneurysmal coiling procedures. Particular care must be taken in the handling of guiding catheters, especially when proving left side great vessels.
Neurointervention. 09/2012; 7(2):77-84.
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ABSTRACT: To evaluate initial radiologic findings of symptomatic intracranial vertebrobasilar dissections (VBDs) as well as the results at follow-up imaging of dissections that are conservatively managed.
The respective institutional review boards approved this retrospective study and waived the need for informed consent. The initial radiologic findings of 210 patients with 230 symptomatic intracranial VBDs were retrospectively evaluated (48 ruptured, 182 unruptured). Those patients had undergone conventional angiography as well as magnetic resonance imaging and/or computed tomographic angiography, so that angiographic shapes and pathognomonic findings (eg, intramural hematoma, intimal flap) could be reviewed. The primary angiographic shapes of the symptomatic intracranial VBDs were subdivided into three groups: (a) dilatation without stenosis, (b) pearl-and-string, and (c) stenosis without dilatation. Furthermore, the radiologic evolution of conservatively managed symptomatic intracranial VBDs was evaluated. The respective frequencies of the radiologic findings at initial and follow-up imaging studies were compared by using χ2 tests.
Primary shape differed significantly between ruptured and unruptured symptomatic intracranial VBDs. Most ruptured dissections presented with one of two main structures: dilatation without stenosis or pearl-and-string appearance. The primary shape of unruptured dissections was evenly distributed among the three types of findings. Intramural hematomas were most frequently found in the stenosis-without-dilatation group (42 of 60 [70%]), followed by the pearl-and-string group (27 of 90 [30%]). Intimal flap was most frequently found in the pearl-and-string group (21 of 90 [23%]), followed by the stenosis-without-dilatation group (eight of 60 [13%]). Follow-up results significantly differed by initial VBD shapes: Seventy-four percent (25 of 34) of the dilatation-without-stenosis group showed no change, whereas improvement was observed in 91% (39 of 43) of the stenosis-without-dilatation group (P<.05). Intracranial VBDs with intramural hematoma showed improvement in 63% (34 of 54) of cases, progression occurred in 20% (11 of 54), and only 17% (nine of 54) exhibited no change (P<.05).
Primary angiographic shapes of symptomatic intracranial VBDs differed between ruptured and unruptured lesions. The stenosis-without-dilatation lesions most frequently exhibited radiologic improvement at follow-up imaging, followed by pearl-and-string and dilatation-without-stenosis lesions.
Radiology 05/2012; 264(1):196-202. · 5.73 Impact Factor
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ABSTRACT: There has been little reported on the endovascular experience of basilar artery (BA) trunk aneurysms due to its low incidence. The purpose of this study is to report the results of endovascular treatment (EVT) of BA trunk aneurysms.
Between 2004 and 2008, eight BA trunk aneurysms were treated by EVT. Five patients presented with subarachnoid hemorrhage, one had intracranial mass effect, and in two of the patients the aneurysms were found incidentally. Four lesions were saccular aneurysms, three of them were found with BA fenestration. Three lesions were dissecting aneurysms and one was a giant fusiform aneurysm. The mean follow-up period of clinical outcome was 17.1 months (range, 6-32 months). Angiographic follow-up data was obtained in six patients for period of a mean of 15.6 months (range, 6-25 months).
Four patients with saccular aneurysms were treated by stent-assisted coil embolization except for one patient that was treated without a stent. Three patients with dissecting aneurysms were treated by a single stent placement. One of these dissecting aneurysms rebled in 4 days after stent placement and was secured by BA occlusion. One giant fusiform aneurysm was treated by bilateral vertebral artery (VA) occlusion after balloon test occlusion. Six patients (75.0%) had excellent or good clinical outcomes, one patient whose aneurysm rebled became vegetative, and one patient with bilateral VA occlusion died. Follow-up angiograms showed that four lesions had complete occlusion and two had neck remnant.
The endovascular catheterization of these lesions tends to be relatively simple compared to more complex neurosurgical approaches. EVT, especially using a stent, could be a valuable therapeutic method in treating BA trunk aneurysms.
Acta Neurochirurgica 08/2011; 153(11):2137-45. · 1.52 Impact Factor
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ABSTRACT: Optimal management of bilateral vertebral artery dissecting aneurysms (bi-VDAs) causing subarachnoid hemorrhage (SAH) remains unclear.
To investigate the treatment methods and outcomes of bi-VDA causing SAH.
Seven patients were treated endovascularly for bi-VDA causing SAH. Treatment methods and outcomes were evaluated retrospectively.
Two patients were treated with 2 overlapping stents for both ruptured and unruptured VDAs, 2 with 2 overlapping stents and coiling for ruptured VDA and with conservative treatment for unruptured VDA, 1 with internal trapping (IT) for ruptured VDA and stent-assisted coiling for unruptured VDA, 1 with IT for ruptured VDA and 2 overlapping stents for unruptured VDA, and 1 with IT for ruptured VDA and a single stent for unruptured VDA. None had rebleeding during follow-up (range, 15-48 months). All patients had favorable outcomes (modified Rankin Scale score, 0-2). On follow-up angiography at 6 to 36 months, 9 treated and 2 untreated VDAs revealed stable or improved state, whereas 3 VDAs in 2 patients showed regrowth. Of the 3 recurring VDAs, 1 was initially treated with IT but recurred owing to retrograde flow to the ipsilateral posterior inferior cerebellar artery (PICA), the second was treated with single stent but enlarged, and the last was treated with 2 overlapping stents and coiling but recurred from the remnant sac harboring the PICA origin. All 3 recurred VDAs were retreated with coiling with or without stent insertion.
Bilateral VDAs presenting with SAH were safely treated with endovascular methods. However, endovascular treatment may be limited for VDAs with PICA origin involvement.
Neurosurgery 07/2011; 70(1 Suppl Operative):75-81; discussion 81. · 2.79 Impact Factor
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ABSTRACT: The incidence and risk factors for recurrence after endovascular treatment of intracranial vertebrobasilar dissecting aneurysms (VBDAs) have not been studied. We aimed to evaluate the incidence and risk factors for recurrence after endovascular treatment of VBDAs.
A total of 111 patients (mean age, 45±10 years) underwent endovascular treatment for 119 VBDAs (ruptured/unruptured=73:46). Incidence and risk factors for recurrence were retrospectively evaluated.
Sixty-two VBDAs were treated by a reconstructive technique by using 1 to 3 overlapping stents with or without coiling, and 57 VBDAs were treated by a deconstructive technique by using proximal occlusion or internal trapping at the dissected segment of the parent artery. Follow-up angiography was available for 97 VBDAs (81.5%) in 89 patients at 3 days to 48 months (median, 13 months) after treatment. There were 13 recurrences: 6 had rebleeding but 7 had no rebleeding. All 6 hemorrhagic recurrences had initially presented with a ruptured form. Ten recurrences were confirmed by angiography, but 3 recurrences with rebleeding did not receive follow-up angiography. The rate of post-treatment recurrence did not differ between reconstructive and deconstructive treatments. Involvement of the posterior inferior cerebellar artery origin (odds ratio=8.026; 95% confidence interval, 1.561 to 41.259; P=0.013) was the only independent risk factor for recurrence.
There was a 13% recurrence after endovascular treatment of VBDAs. Posterior inferior cerebellar artery origin involvement was the only independent risk factor for recurrence after endovascular treatment of VBDAs.
Stroke 07/2011; 42(9):2425-30. · 5.73 Impact Factor
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ABSTRACT: To correlate collateral flow on multiphasic contrast enhancement computed tomography (CT) and graded ischemic changes on diffusion weighted MR in patients with acute middle cerebral artery (MCA) infarction.
A retrospective evaluation of diffusion weighted images (DWIs) and three phasic contrast enhanced CT (CECT) was performed on 11 patients with MCA occlusions. The area of ischemic change on DWIs was graded according to the Alberta Stroke Program Early CT Score (ASPECTS) criteria. To evaluate collateral flow on three phasic CECT, we counted the number of contrast enhancing MCA branches distal to the occlusion site at the sylvian fissure from predetermined axial images. The collateral ratios of counted numbers to those at the normal side were calculated at each phase (CR1, CR2, CR3). We then compared collateral ratios from the three phasic CECT with ASPECTS data from DWIs.
Collateral ratios from the three phasic CECT were determined to be CR1 .48 ± .27, CR2 .73 ± .36 and CR3 .72 ± .30. We discovered a correlation between both the CR2 and ASPECTS (r= .675, P= .023) and the CR3 and ASPECTS (r= .664, P= .026).
The number of contrast enhancing branches distal to the MCA occlusion, as counted in the sylvian fissure on later phase images of multiphasic CECT, reflects the status of collateral flow, and correlates with ASPECTS on DWIs.
Journal of neuroimaging: official journal of the American Society of Neuroimaging 07/2011; 21(3):225-8. · 1.72 Impact Factor
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Neurosurgery 06/2011; 69(4):E1030-2. · 2.79 Impact Factor
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ABSTRACT: This prospective, non-randomized study compared the safety and efficacy of the Angio-Seal™ Evolution™ to that of manual compression for common femoral artery punctures in neurovascular diagnostic angiography.
From June 2009 to September 2009, we performed 169 diagnostic trans-femoral cerebral angiographies, using either the Angio-Seal™ Evolution™ or manual compression to achieve hemostasis. We included 60 patients in this study, 30 in each group. We defined minor complications as those requiring no further treatment such as hematoma size less than 6 cm and bruise size less than 25 cm. Major complications were those requiring surgery of the femoral artery pseudoaneurysm and/or the second line increase of hospital stay even without further treatment.
Mean time to hemostasis was 0.42±0.04 minutes for the angioseal and 15.83±1.63 minutes for manual compression (p<0.001). Overall complication rate did not differ between the 2 groups. After the patients were fully mobile, at 24 hours, the rate of onset of new complication differed significantly between the 2 groups (p=0.032). In the angioseal group, 5 (16.7%) of the 30 patients experienced the onset of a new complication after 24 hours, including 3 (60.0%) of the 5 who experienced major complications.
The Angio-Seal™ Evolution™ is effective at decreasing mean time to hemostasis, like other closing devices. However, it may not be effective at producing early ambulation and discharge, compared to manual compression, because delayed complications may occur significantly after 24 hours.
Journal of Korean Neurosurgical Society 03/2011; 49(3):153-6. · 0.60 Impact Factor
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ABSTRACT: the purpose of this study is to suggest the landmarks for decompressive craniectomy so that surgery can be standardized to achieve adequate decompression in patients with malignant middle cerebral artery infarction. We also analyzed the efficacy and safety of this newly suggested surgical method.
eleven patients (group A) underwent this newly suggested decompressive surgery. The bony landmarks for decompressive craniectomy are described. The area of the bone flap and the brain volume protruding out of the skull surface were measured. The outcomes were evaluated 3 months after the surgery. All the results were compared with that of 13 patients (group B) who were treated with conventional surgical methods.
the mean area of craniectomy was larger in group A (399.9 ± 50.9 cm) than that in group B (308.5 ± 50.5 cm, P=0.021). The brain volume protruding out of the skull surface was 161.8 ± 101.7 cm in group A and 106.3 ± 55.1 cm in group B, indicating that more decompression was performed in group A (P=0.034). Six (54.5%) of 11 patients in group A had favorable outcomes (modified Rankin Scale 0 to 3) without mortality, whereas 2 (15.4%) of 13 patients in group B had favorable outcomes and 3 (23.1%) patients in group B expired.
decompressive craniectomy using the newly suggested method is feasible and safe, and it may be more beneficial, compared with conventional craniectomy, for patients with malignant middle cerebral artery infarction. Furthermore, it may be easier to perform by training neurosurgeons.
The Neurologist 01/2011; 17(1):11-5. · 1.26 Impact Factor
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ABSTRACT: We report a patient with a right vertebral artery (VA) dissecting aneurysm who was treated by placing an Enterprise stent (Cordis Neurovascular, Miami Lakes, FL) from the proximal VA to the posterior inferior cerebellar artery (PICA) in order to save the patency of the PICA. A 47-year-old man was admitted with a ruptured right VA dissecting aneurysm that involved the origin of the PICA. A 4.5 x 37-mm Enterprise stent was then placed through the proximal VA to the PICA. The dissected segment of the VA was completely occluded by coil embolization. The 1-year follow-up angiography showed that the dissected segment was completely occluded and the diameter of the PICA was slightly increased, and the PICA's patency was good.
Acta Neurochirurgica 09/2010; 152(9):1489-92. · 1.52 Impact Factor
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ABSTRACT: An increasing number of patients with incompletely treated and recurrent intracranial aneurysms are presenting for further management. We review the patients who underwent microsurgical clipping of previously coiled intracranial aneurysms.
From 2001 to 2008, we treated 623 aneurysms by endovascular treatment. Among them, 29 patients underwent microsurgical clipping. Nineteen patients (group A) underwent early surgical intervention due to incomplete coiling, a residual neck, coil protrusion, aneurysm rupture, or coil stretching. Ten patients (group B) underwent surgical clipping for recurrent aneurysm and an increased mass effect during the follow-up period. The radiographic images and clinical data were reviewed retrospectively to determine the treatment efficacy, the clinical outcomes, and the factors that are important to select the proper treatment modality.
There were 13 female and 16 male patients. The coils were removed in 6 of the 19 patients in group A and in 1 of the 10 patients in group B. Seventeen (89.5%) of the 19 patients in group A and all the patients (100%) in group B achieved good recovery (Glasgow Outcome Scale 5 and 4) during the clinical follow-up periods (mean 25.2 months).
Microsurgical clipping may be chosen as a safe and permanent treatment option for the previously coiled aneurysms with acceptable morbidity in properly selected cases.
Neuroradiology 04/2010; 52(12):1143-51. · 2.82 Impact Factor
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European Neurology 12/2009; 63(1):62-3. · 1.81 Impact Factor
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ABSTRACT: Resection of the anterior clinoid process (ACP) for the clipping of an internal carotid-posterior communicating artery aneurysm is rarely needed. However, preoperative awareness of the necessity of anterior clinoidectomy is essential for safe clipping of the lesions. We investigated the preoperative predictive value for anterior clinoidectomy in treating internal carotid-posterior communicating artery aneurysms.
We retrospectively reviewed all patients with a posterior communicating artery aneurysm treated with clipping in the past 5 years. Only the patients who underwent both computed tomographic angiography and 4-vessel digital subtraction angiography were included in this study. We measured several angles and distances on these images, and compared the parameters measured between an anterior clinoidectomy group and a non-anterior clinoidectomy group. A P value of less than 0.05 was considered significant.
We examined 94 cases of posterior communicating artery aneurysms treated with clipping. The ACP was resected in 6 of the 94 cases. In the anterior clinoidectomy group, there were 3 factors that were statistically significant. First, the calculated real distance between the ACP and the aneurysmal neck was shorter (mean, 4.4 +/- 0.7 versus 7.2 +/- 1.4 mm). Second, the angle between vertical line to cranial base and communicating segment of the internal carotid artery (ICA) was larger (mean, 62.5 +/- 4.6 versus 50.9 +/- 10.7 degrees). Third, the angle between the communicating segment and the ophthalmic segment of the ICA was smaller (mean, 66.5 +/- 15.1 versus 84.6 +/- 20.4 degrees).
The anterior clinoidectomy group showed a more tortuous course of intracranial ICA around the ACP than the nonclinoidectomy group. Therefore, measurement of the distal ICA angle is helpful in predicting the necessity of anterior clinoidectomy.
Neurosurgery 09/2009; 65(2):281-5; discussion 285-6. · 2.79 Impact Factor
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ABSTRACT: The purpose of this study was to analyze the clinical outcome of 75 consecutive patients with cervical carotid artery stenosis and who were treated by carotid artery stenting (CAS) only.
From February 2003 to June 2008, there were 78 stents placed in 75 symptomatic patients (mean age : 67.3 years); 69 patients had carotid stenosis >/=70%, and 6 patients had asymptomatic stenosis >/=80%. No carotid endarterectomy (CEA) was performed during the same period. The patients were clinically followed-up for a mean of 20.1 months.
The procedures were technically successful in all cases. Three (3.8%) patients had procedure-related complications. During the 30-day postprocedural period, there were no restenosis or major stroke. Minor stroke was noticed in 3 (3.8%) patients and 1 (1.3%) of the 75 patients suddenly expired 2 days after discharge. There were no new neurological symptoms that developed during the clinical follow-up period. The results of our series were not inferior to those the previously published in CAS studies, and in fact they were better.
Our results suggest that CAS may be safe and useful for the treatment of cervical carotid artery stenosis when it is used as the first line treatment in those institutions that lack enough experience with CEA.
Journal of Korean Neurosurgical Society 06/2009; 45(6):350-4. · 0.60 Impact Factor
