To describe the successful endovascular treatment in a nonagenarian with symptomatic internal carotid artery stenosis using direct carotid artery access. An independent 98 year-old man was admitted to our hospital for...To describe the successful endovascular treatment in a nonagenarian with symptomatic internal carotid artery stenosis using direct carotid artery access. An independent 98 year-old man was admitted to our hospital for symptoms of progressive weakness with disorientation and dysphasia. Carotid Duplex ultrasonography was performed which revealed a totally occluded right internal carotid artery and high grade stenosis of the left internal carotid artery by velocities of 608/240 cm/sec. The patient refused surgical endarterectomy and thus he was referred for carotid artery stenting. Using the femoral artery approach and multiple catheter techniques, access to the common carotid artery could not be accomplished safely. The procedure was aborted and he was therefore brought back to the catheterization laboratory the following day for direct carotid access. Carotid artery stenting was accomplished by using of a 6F sheath percutaneously in the left common carotid, cerebral protection device (CPD) and a Nitinol stent. The patient was discharged the following day without complications. At 14 months follow-up the patient is functional and independent without recurrence of symptoms. Carotid artery stenting via direct access can be accomplished in patients when the femoral artery approach is anatomically prohibitive. In this case of advanced age and the patient’s refusal for surgery, direct carotid access was his only option.展开更多
Objective Intracranial internal carotid artery dissection is a rare case. The purpose of this study was to report the treatment of intracranial internal carotid dissection and the radiologic and clinical result.Materi...Objective Intracranial internal carotid artery dissection is a rare case. The purpose of this study was to report the treatment of intracranial internal carotid dissection and the radiologic and clinical result.Material And Method A 67 year-old female patient admitted for lower leg fracture at the outside university hospital. After 6 days later, she presented with left hemiparesis, verbal disturbance and visual disturbance. She transferred to our hospital and evaluated with MRI and Angiography. Angiography show stenosis with ulceration and pseudoaneurysm at the internal carotid artery. The stenosis rate was 63%. At the lesion, ophthalmic artery was poor visualized. Results The intracranial lesion was treated with angioplasty and stenting. After stenting, angiography showed good ophthalmic artery flow. Patients improved visual acuity just after stenting. Conclusions Intracranial angioplasty and stenting will be a good treatment option in a highly selected case.展开更多
文摘To describe the successful endovascular treatment in a nonagenarian with symptomatic internal carotid artery stenosis using direct carotid artery access. An independent 98 year-old man was admitted to our hospital for symptoms of progressive weakness with disorientation and dysphasia. Carotid Duplex ultrasonography was performed which revealed a totally occluded right internal carotid artery and high grade stenosis of the left internal carotid artery by velocities of 608/240 cm/sec. The patient refused surgical endarterectomy and thus he was referred for carotid artery stenting. Using the femoral artery approach and multiple catheter techniques, access to the common carotid artery could not be accomplished safely. The procedure was aborted and he was therefore brought back to the catheterization laboratory the following day for direct carotid access. Carotid artery stenting was accomplished by using of a 6F sheath percutaneously in the left common carotid, cerebral protection device (CPD) and a Nitinol stent. The patient was discharged the following day without complications. At 14 months follow-up the patient is functional and independent without recurrence of symptoms. Carotid artery stenting via direct access can be accomplished in patients when the femoral artery approach is anatomically prohibitive. In this case of advanced age and the patient’s refusal for surgery, direct carotid access was his only option.
文摘Objective Intracranial internal carotid artery dissection is a rare case. The purpose of this study was to report the treatment of intracranial internal carotid dissection and the radiologic and clinical result.Material And Method A 67 year-old female patient admitted for lower leg fracture at the outside university hospital. After 6 days later, she presented with left hemiparesis, verbal disturbance and visual disturbance. She transferred to our hospital and evaluated with MRI and Angiography. Angiography show stenosis with ulceration and pseudoaneurysm at the internal carotid artery. The stenosis rate was 63%. At the lesion, ophthalmic artery was poor visualized. Results The intracranial lesion was treated with angioplasty and stenting. After stenting, angiography showed good ophthalmic artery flow. Patients improved visual acuity just after stenting. Conclusions Intracranial angioplasty and stenting will be a good treatment option in a highly selected case.
