Carotid artery stenting: a therapeutic alternative in subtotal internal carotid artery occlusions.
Carotid artery stenting (CAS) is emerging as a less invasive modality for treating atherosclerotic occlusive disease of the internal carotid artery (ICA). Randomized trials like the SAPPHIRE trial have demonstrated that CAS is not inferior to carotid endarterectomy (CEA) in the treatment of carotid artery stenosis, and maybe even superior in high-risk symptomatic patients. However, patients with subtotal ICA occlusions with thrombus are excluded from randomized CAS trials and CAS registries. To our knowledge, carotid angioplasty with stenting has not been attempted in these cases. We present three cases of symptomatic subtotal ICA occlusions successfully treated with CAS without any periprocedural complications. With careful patient selection and technical expertise, endovascular management could be considered as a treatment option in subtotal carotid occlusions.
Zacharias
Soni J
SJ
Department of Internal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
Kalapura
Thomachan
T
Abrantes-Pais
Fatima
F
Hennebry
Thomas A
TA
D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D017130:Angioplasty; D002340:Carotid Artery Diseases / Q000517:prevention & control / Q000601:surgery*; D002343:Carotid Artery, Internal / Q000473:pathology*; D016893:Carotid Stenosis / Q000517:prevention & control / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents