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01-07-2016 | Interventional Neuroradiology

Duplex-assisted carotid artery stenting without administration of contrast medium for patients with chronic kidney disease or allergic reaction

Authors: Takashi Mizowaki, Atsushi Fujita, Taichiro Imahori, Atsushi Uyama, Satoshi Inoue, Masaaki Kohta, Hirotoshi Hamaguchi, Takashi Sasayama, Kohkichi Hosoda, Eiji Kohmura

Published in: Neuroradiology | Issue 7/2016

Abstract

Introduction

We aimed to investigate the safety and feasibility of duplex-assisted carotid artery stenting (CAS) without administration of contrast medium for the prevention of adverse reactions.

Methods

Fifteen patients (9 % of all CASs) with severe carotid stenosis (≥70 %) associated with chronic kidney disease (CKD) (stage ≥3) or allergy to contrast medium underwent duplex-assisted CAS without administration of contrast medium over 4 years. The procedural success rate and perioperative complication rates were compared between the duplex-assisted CAS (n = 15) and conventional CAS (n = 153) groups.

Results

The technical success rate was 100 % in both groups. Combined stroke or death rates during the post-procedural period did not differ significantly between the duplex-assisted CAS group (0/15, 0 %) and conventional CAS group (4/153, 2.6 %). None of the 14 patients with CKD in the duplex-assisted CAS group experienced further deterioration of renal function. The mean surface radiation dose of participants in the duplex-assisted CAS group (n = 13, 312 ± 131 mGy) was significantly lower than that of the conventional CAS group (n = 31, 1036 ± 571 mGy) (p < 0.001). The mean duration of CAS procedure was not significantly different between the duplex-assisted CAS group (156 ± 39.7 min) and the conventional CAS group (156 ± 37.4 min).

Conclusion

Duplex-assisted CAS without administration of contrast medium could be an alternative option in selected patients deemed to be at high risk for renal failure from nephrotoxic contrast medium or who have an allergy to contrast medium.

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Title: Duplex-assisted carotid artery stenting without administration of contrast medium for patients with chronic kidney disease or allergic reaction
Authors: Takashi Mizowaki
Atsushi Fujita
Taichiro Imahori
Atsushi Uyama
Satoshi Inoue
Masaaki Kohta
Hirotoshi Hamaguchi
Takashi Sasayama
Kohkichi Hosoda
Eiji Kohmura
Publication date: 01-07-2016
Publisher: Springer Berlin Heidelberg
Published in: Neuroradiology / Issue 7/2016
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI: https://doi.org/10.1007/s00234-016-1678-x

At a glance: The STEP trials

Springer Medicine

Duplex-assisted carotid artery stenting without administration of contrast medium for patients with chronic kidney disease or allergic reaction

Abstract

Introduction

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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