清晨好,您是今天最早来到科研通的研友!由于当前在线用户较少,发布求助请尽量完整地填写文献信息,科研通机器人24小时在线,伴您科研之路漫漫前行!

Concomitant ipsilateral carotid endarterectomy and stenting is an effective treatment for tandem carotid artery lesions

医学 颈动脉内膜切除术 围手术期 动脉内膜切除术 颈总动脉 颈动脉疾病 狭窄 外科 相伴的 颈动脉支架置入术 放射科 支架 颈动脉 冲程(发动机) 机械工程 工程类
作者
Jocelyn M. Beach,Shashank Sharma,Jim Bena,Jeanwan Kang,Daniel G. Clair,Christopher J. Smolock
出处
期刊:Journal of Vascular Surgery [Elsevier BV]
卷期号:71 (5): 1579-1586 被引量:6
标识
DOI:10.1016/j.jvs.2019.07.054
摘要

Abstract Objective Data regarding the treatment of tandem carotid artery lesions at the bifurcation and ipsilateral, proximal common carotid artery (CCA) are limited. It has been suggested that concomitant treatment with carotid endarterectomy (CEA) and proximal ipsilateral carotid artery stenting confers a high risk of stroke and death. The objective of this study was to evaluate the technique and outcomes of this hybrid procedure at a single institution. Methods A retrospective chart review was performed including patients who underwent CEA + ipsilateral carotid artery stenting for treatment of atherosclerotic carotid artery disease between December 2007 and April 2017. Primary endpoints were postoperative myocardial infarction, neurologic event, and perioperative mortality. Results Twenty-two patients (15 male [68%]) underwent CEA + ipsilateral carotid artery stenting with a mean follow-up of 67 ± 77 months. The mean age was 70.0 ± 6.1 years old, all with a prior smoking history (eight current smokers [64%]). Twelve patients (55%) were treated for symptomatic disease and three had a prior ipsilateral CEA (one also with CAS). Computed tomographic angiography imaging was performed preoperatively in 21 patients (95%). CEA was performed first in 18 patients (82%) followed by ipsilateral carotid artery stenting. CEA was performed with a patch in 20 and eversion endarterectomy in two patients. Ipsilateral CCA was stented in 21 patients (96%) and one innominate was stented in a patient with a right CEA. Additional endovascular interventions were performed in three patients: 1 innominate stent, 1 distal ipsilateral internal carotid artery stent, and 1 right subclavian artery stent. All proximal stents were placed with sheath access through the endarterectomy patch in 12 (55%), CCA in 7 (32%), and through the arteriotomy before patching in 3 (14%). Distal internal carotid artery clamping was performed in 18 (90%, available 20) of patients before ipsilateral carotid artery stenting. All proximal lesions were successfully treated endovascularly with no open conversion. One dissection was created and treated effectively with stenting. One perioperative stroke (4.5%) occurred in a patient treated for symptomatic disease, 1 postoperative myocardial infarction (4.5%), and 2 patients (9.1%) with cranial nerve injuries. There was one patient who expired within 30 days, shortly after discharge for unknown reasons. The mean length of stay was 2.6 ± 2.0 days. Conclusions In appropriately selected patients, concomitant CEA and ipsilateral carotid artery stenting can be safely performed in high-risk patients with a low risk of myocardial infarction, neurologic events, and perioperative mortality when careful surgical technique is used, using direct carotid access, and distal carotid clamping for cerebral protection before stenting.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
18秒前
wjx完成签到 ,获得积分10
20秒前
俏皮元珊完成签到 ,获得积分10
22秒前
24秒前
大个应助科研通管家采纳,获得20
31秒前
搜集达人应助科研通管家采纳,获得30
31秒前
elisa828发布了新的文献求助10
36秒前
zijingsy完成签到 ,获得积分10
42秒前
Owen应助像风一样采纳,获得10
43秒前
单小芫完成签到 ,获得积分10
53秒前
54秒前
像风一样完成签到,获得积分20
56秒前
像风一样发布了新的文献求助10
59秒前
1分钟前
深情安青应助念臻采纳,获得10
1分钟前
六六吃了梅完成签到,获得积分20
1分钟前
Jally完成签到 ,获得积分10
1分钟前
王洋完成签到,获得积分10
1分钟前
myq完成签到 ,获得积分10
1分钟前
念臻完成签到,获得积分10
1分钟前
1分钟前
枫威完成签到 ,获得积分10
1分钟前
念臻发布了新的文献求助10
1分钟前
lod完成签到,获得积分10
1分钟前
香锅不要辣完成签到 ,获得积分10
1分钟前
1分钟前
elisa828发布了新的文献求助10
1分钟前
Alex-Song完成签到 ,获得积分0
1分钟前
我是老大应助无限的以亦采纳,获得10
1分钟前
门住完成签到 ,获得积分10
2分钟前
elisa828发布了新的文献求助10
2分钟前
胡国伦完成签到 ,获得积分10
2分钟前
科研通AI2S应助科研通管家采纳,获得10
2分钟前
李东东完成签到 ,获得积分10
2分钟前
自然的含蕾完成签到 ,获得积分10
2分钟前
nuliguan完成签到 ,获得积分10
2分钟前
3分钟前
Alisha完成签到,获得积分10
3分钟前
双子土豆泥完成签到 ,获得积分10
3分钟前
任伟超完成签到,获得积分10
3分钟前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
Cognitive Neuroscience: The Biology of the Mind 1000
Technical Brochure TB 814: LPIT applications in HV gas insulated switchgear 1000
Immigrant Incorporation in East Asian Democracies 600
Nucleophilic substitution in azasydnone-modified dinitroanisoles 500
不知道标题是什么 500
A Preliminary Study on Correlation Between Independent Components of Facial Thermal Images and Subjective Assessment of Chronic Stress 500
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3968521
求助须知:如何正确求助?哪些是违规求助? 3513341
关于积分的说明 11167298
捐赠科研通 3248700
什么是DOI,文献DOI怎么找? 1794434
邀请新用户注册赠送积分活动 875030
科研通“疑难数据库(出版商)”最低求助积分说明 804664