Journal article
Endovascular Treatment of Proximal Aortic Arch Lesions through a Retrograde Approach
Interventional neurology, Vol.3(1), pp.41-47
01/2015
DOI: 10.1159/000369302
PMCID: PMC4436530
PMID: 25999991
Abstract
Tandem atherosclerotic lesions of the carotid bifurcation and the ipsilateral proximal common carotid artery (CCA) or innominate arteries (IA) can be challenging to treat. A surgical approach may treat the lesion at the carotid bifurcation, but proximal CCA or IA lesions require a major surgical exposure. An endovascular approach is challenging as well since anatomic variations, such as a type III aortic arch, can render navigation very difficult. We report our experience in the hybrid surgical and endovascular treatment of complex proximal CCA and IA lesions. Eleven patients who underwent hybrid procedures with surgical exposure (with or without endarterectomy) of the carotid artery and retrograde endovascular intervention of a proximal lesion were included in the study. The mean percentage of stenosis was 81%. Seven patients underwent a carotid endarterectomy (CEA), and 4 patients underwent only a surgical cutdown for retrograde endovascular access of the IA or left CCA. All procedures were technically successful. Eight patients had no symptoms within 30 days of the procedure. The hybrid retrograde endovascular approach through carotid exposure with or without CEA appears to be effective and safe in selected patients who have a high-risk complex anatomy of tandem lesions.
Details
- Title: Subtitle
- Endovascular Treatment of Proximal Aortic Arch Lesions through a Retrograde Approach
- Creators
- Edgar A Samaniego - Departamento de Cirugía Neuroendovascular, Hospital Eugenio Espejo, Quito, Ecuador, Fla., USABarry T Katzen - Division of Vascular and Interventional Radiology, Baptist Cardiac and Vascular Institute, Miami, Fla., USAAndreas S Kreusch - Department of Radiology, Cantonal Hospital Winterthur, Winterthur, SwitzerlandHeiko Uthoff - Department of Angiology, University Hospital Basel, Basel, Switzerland
- Resource Type
- Journal article
- Publication Details
- Interventional neurology, Vol.3(1), pp.41-47
- Publisher
- S. Karger AG
- DOI
- 10.1159/000369302
- PMID
- 25999991
- PMCID
- PMC4436530
- ISSN
- 1664-9737
- eISSN
- 1664-5545
- Language
- English
- Date published
- 01/2015
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984020768102771
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