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Acta Neurochirurgica

Published in:

01-06-2018 | Original Article - Vascular

Predictors of antegrade flow at internal carotid artery during carotid artery stenting with proximal protection

Authors: Kei Harada, Kosuke Kakumoto, Shogo Oshikata, Kozo Fukuyama

Published in: Acta Neurochirurgica | Issue 6/2018

Abstract

Background

Carotid artery stenting (CAS) with proximal occlusion effectively prevent distal cerebral embolism by flow arrest at internal carotid artery (ICA); however, the method can expose antegrade flow at ICA due to incomplete flow arrest. The aim of this study was to identify predictors of antegrade flow during CAS with proximal protection.

Methods

We retrospectively analyzed clinical and angiographic data among 143 lesions treated with CAS with proximal protection by occluding the common carotid artery (CCA) and external carotid artery (ECA). Flow arrest or antegrade flow at ICA was confirmed by contrast injection during proximal protection.

Results

Antegrade flow at ICA was observed in 12 lesions (8.4%). Compared with lesions in which flow arrest of ICA was achieved, the diameter of the superior thyroid artery (STA) was significantly larger (2.4 ± 0.34 vs. 1.4 ± 0.68 mm, p < 0.001), and the rate of ECA branches other than the STA located 0–10 mm above the bifurcation was significantly higher (50 vs. 8.4%, p < 0.001). Results of multivariate analysis revealed that a diameter of the STA ≥ 2.3 mm (OR 44, 95% CI 8.1–237; p < 0.001) and ECA branches other than the STA located 0–10 mm above the bifurcation (OR 6.0, 95% CI 1.1–32; p = 0.036) were independent predictors of antegrade flow.

Conclusions

Distal filter protection should be combined with proximal protection for the lesions with antegrade flow to prevent distal migration of the carotid debris.

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Title: Predictors of antegrade flow at internal carotid artery during carotid artery stenting with proximal protection
Authors: Kei Harada
Kosuke Kakumoto
Shogo Oshikata
Kozo Fukuyama
Publication date: 01-06-2018
Publisher: Springer Vienna
Published in: Acta Neurochirurgica / Issue 6/2018
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-018-3487-y

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Predictors of antegrade flow at internal carotid artery during carotid artery stenting with proximal protection

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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