title: Carotid artery stenting using the proximal or dual protection method for near occlusion of the cervical internal carotid artery.
abstract: The treatment for patients with near occlusion of the cervical internal carotid artery (ICA) is controversial. The aim of this study was to examine the results of carotid artery stenting (CAS) as a surgical treatment for ICA near occlusion. Between April 2008 and September 2012, 14 patients (all men; mean age, 75.4 years) with ICA near occlusion were treated with CAS. This represents 5.2% of a total of 267 patients treated with CAS during the study period. All patients were treated with CAS using an embolic protection device. The proximal balloon protection method was performed in five patients, and the dual protection method using a proximal balloon and distal filter protection was used in nine patients. We examined the change of stenotic lesion, hyperintensity spot in diffusion-weighted imaging (DWI), and perioperative complications after CAS. All near occlusions were successfully dilated. Among 2 of 14 patients, DWI showed 1 and 4 hyperintensity spots. Transient and persistent complications, including neurological deficits, did not occur in any patients. In this small number of cases, CAS using the proximal or dual embolic protection method seems to be a safe and beneficial treatment for ICA near occlusion.
authors.affiliation: Department of Neurosurgery, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3 Kasumi,, Minami-ku, Hiroshima, 734-8551, Japan, sakamoto@hiroshima-u.ac.jp.
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Sakamoto
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kiura
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Kajihara
authors.forename: Masaaki
authors.initials: M
authors.lastname: Shibukawa
authors.forename: Takahito
authors.initials: T
authors.lastname: Okazaki
authors.forename: Toshinori
authors.initials: T
authors.lastname: Matsushige
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Shinagawa
authors.forename: Kazutoshi
authors.initials: K
authors.lastname: Mukada
authors.forename: Kaoru
authors.initials: K
authors.lastname: Kurisu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon; D002343:Carotid Artery, Internal / Q000601:surgery*; D016893:Carotid Stenosis / Q000601:surgery*; D038524:Diffusion Magnetic Resonance Imaging; D004106:Dilatation; D004617:Embolism / Q000517:prevention & control; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D005268:Femoral Vein; D006801:Humans; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000209:etiology / Q000601:surgery; D011184:Postoperative Period; D015607:Stents; D016896:Treatment Outcome