Title :

Angiographic patterns and outcomes achieved by proximal balloon occlusion in symptomatic carotid artery stenosis stenting

Author(s) :

Dargazanli, Cyril [Auteur]
Hôpital Gui de Chauliac [CHU Montpellier]
Mahmoudi, Mehdi [Auteur]
Cappucci, Matteo [Auteur]
Collemiche, François-Louis [Auteur]
Labreuche, Julien [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Habza, Othmane [Auteur]
Gascou, Gregory [Auteur]
Lefevre, Pierre-Henri [Auteur]
Eker, Omer [Auteur]
Mourand, Isabelle [Auteur]
Gaillard, Nicolas [Auteur]
Charif, Mahmoud [Auteur]
Derraz, Imad [Auteur]
Arquizan, Caroline [Auteur]
Costalat, Vincent [Auteur]

Journal title :

Clinical Neuroradiology

Abbreviated title :

Clin Neuroradiol

Volume number :

30

Pages :

363-372

Publisher :

Springer

Publication date :

2019-03-07

ISSN :

1869-1447

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

OBJECTIVE: The best embolic protection strategy has not yet been established for carotid artery stenting (CAS). This article reports a new simplified approach using a balloon guide catheter inspired by stroke therapy, in ...
Show more >OBJECTIVE: The best embolic protection strategy has not yet been established for carotid artery stenting (CAS). This article reports a new simplified approach using a balloon guide catheter inspired by stroke therapy, in patients harboring a symptomatic ICA atherosclerotic stenosis or web. In addition, the three angiographic patterns and clinical outcomes associated with this technique, called the simple flow blockage (SFB) technique are described. METHODS: This was a retrospective study with data extraction from a monocentric prospective clinical registry of consecutive patients admitted for symptomatic ICA stenosis or web. The primary study outcome (composite endpoint) was the rate of occurrence of death, symptomatic stroke or acute coronary syndrome within 30 days of the intervention. RESULTS: In this study 75 symptomatic patients with >50% carotid artery atherosclerotic stenosis or web were included. All procedures were successfully performed. The composite endpoint occurred in 3 patients (4.0%, 95% confidence interval, CI, 0.0-11.3): 1 had symptomatic ischemic stroke, 1 had reperfusion syndrome with symptomatic intracranial hemorrhage and 1 had acute coronary syndrome. After proximal balloon inflation three angiographic patterns were observed: complete contrast column stagnation in the ICA (38.7%), retrograde washout of the ICA from the intracranial circulation towards the external carotid artery (35.5%) and antegrade washout of contrast medium towards the intracranial circulation (25.8%). The median procedure length was 40 min. New asymptomatic ischemic lesions were observed in 22.5% on DWI-MRI. CONCLUSIONS: The SFB technique enables fast and safe procedures in CAS. A favorable angiographic pattern after proximal balloon inflation was observed in 74.2% of cases.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

CHU Lille
Université de Lille

Collections :

• METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Submission date :

2019-12-09T16:48:18Z
2024-03-22T10:32:20Z