title: Retrograde supra-aortic stent placement combined with open carotid or subclavian artery revascularization.
abstract: OBJECTIVE
  To review the outcomes of retrograde supra-aortic vessel stent (RSAS) placement combined with open carotid or subclavian artery revascularization.
  
  
  METHODS
  Retrospective review of all consecutive patients between 1995 and 2010, excluding transfemoral procedures or isolated retrograde stent placement.
  
  
  RESULTS
  There were 11 patients (9 females, mean age 65 years). Open revascularization included carotid endarterectomy in 6 patients, carotid-subclavian bypass in 3, and carotid-carotid bypass in 2 patients. There were no operative deaths or neurological events. All symptomatic patients improved. Over a mean follow-up of 24 months, One patient developed common carotid artery (CCA) in-stent dissection and symptomatic restenosis treated with subclavian-carotid bypass. Another 3 patients had asymptomatic restenosis of the carotid bifurcation but required no intervention.
  
  
  CONCLUSIONS
  Retrograde stenting of the common carotid or innominate artery is a safe and effective method to provide inflow in selected patients with severe supra-aortic vessel disease who require concomitant open carotid or subclavian artery reconstructions.
authors.affiliation: Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: Nitin
authors.initials: N
authors.lastname: Garg
authors.forename: Gustavo S
authors.initials: GS
authors.lastname: Oderich
authors.forename: Audra A
authors.initials: AA
authors.lastname: Duncan
authors.forename: Gautam
authors.initials: G
authors.lastname: Agarwal
authors.forename: Manju
authors.initials: M
authors.lastname: Kalra
authors.forename: Peter
authors.initials: P
authors.lastname: Gloviczki
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Bower
mesh_terms: D000368:Aged; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000295:instrumentation*; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000601:surgery / Q000628:therapy*; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000601:surgery*; D016893:Carotid Stenosis / Q000175:diagnosis / Q000601:surgery / Q000628:therapy*; D003131:Combined Modality Therapy; D016894:Endarterectomy, Carotid / Q000009:adverse effects; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D015607:Stents; D013348:Subclavian Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex