Open Retrograde Stenting of Proximal Innominate and Common Carotid Artery Stenosis
Purpose: The evidence regarding the treatment of open retrograde stenting of innominate artery (IA) or common carotid artery stenosis (CCA) is limited, and is suspected to carry a high risk of stroke and death. Therefore, the objective of this study was to evaluate the outcomes of such hybrid proced...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2024-02-01
|
| Series: | Journal of Personalized Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2075-4426/14/3/223 |
| _version_ | 1797240440615862272 |
|---|---|
| author | Marvin Kapalla Albert Busch Steffen Wolk Christian Reeps |
| author_facet | Marvin Kapalla Albert Busch Steffen Wolk Christian Reeps |
| author_sort | Marvin Kapalla |
| collection | DOAJ |
| description | Purpose: The evidence regarding the treatment of open retrograde stenting of innominate artery (IA) or common carotid artery stenosis (CCA) is limited, and is suspected to carry a high risk of stroke and death. Therefore, the objective of this study was to evaluate the outcomes of such hybrid procedures. Methods: A retrospective, monocentric study of all patients who underwent retrograde stenting of proximal IA and CCA stenosis via surgical cutdown of the CCA, with or without concomitant CEA, between 2016 and 2023 was performed. Results: Overall, 33 patients were treated. A total of 15 patients (45.5%) were male, with the mean age being 67 ± 9.1 years, and 58% (n = 19) of the patients presented with neurological symptoms. Open retrograde stenting was performed in 67% (n = 22) in ACC, and in 33% (n = 11) in IA stenosis. A total of 20 patients (61%) underwent retrograde stenting with synchronous ipsilateral CEA for concomitant stenosis of the carotid bifurcation. There was no 30-day mortality. The perioperative stroke rate was 3% (n = 1) with complete symptom recovery. During the follow up at 32 months (95% CI: 24–39), three late deaths (9.1%) and one symptomatic stent occlusion were observed and, in five patients (15.2%), re-intervention for restenosis was necessary. Conclusions: Open retrograde stenting for of proximal IA or CCA stenosis with or without CEA, in case of tandem carotid lesions, can be performed safely with a low rate of early adverse events. Continuous follow up examinations are necessary due to relevant instent re-stenosis rates. |
| first_indexed | 2024-04-24T18:07:28Z |
| format | Article |
| id | doaj.art-d8141af6d08c48deb8ac20f674aa8da9 |
| institution | Directory Open Access Journal |
| issn | 2075-4426 |
| language | English |
| last_indexed | 2024-04-24T18:07:28Z |
| publishDate | 2024-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Personalized Medicine |
| spelling | doaj.art-d8141af6d08c48deb8ac20f674aa8da92024-03-27T13:49:59ZengMDPI AGJournal of Personalized Medicine2075-44262024-02-0114322310.3390/jpm14030223Open Retrograde Stenting of Proximal Innominate and Common Carotid Artery StenosisMarvin Kapalla0Albert Busch1Steffen Wolk2Christian Reeps3Department of Visceral, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technical University of Dresden—TU Dresden, 01307 Dresden, GermanyDepartment of Visceral, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technical University of Dresden—TU Dresden, 01307 Dresden, GermanyDepartment of Visceral, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technical University of Dresden—TU Dresden, 01307 Dresden, GermanyDepartment of Visceral, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technical University of Dresden—TU Dresden, 01307 Dresden, GermanyPurpose: The evidence regarding the treatment of open retrograde stenting of innominate artery (IA) or common carotid artery stenosis (CCA) is limited, and is suspected to carry a high risk of stroke and death. Therefore, the objective of this study was to evaluate the outcomes of such hybrid procedures. Methods: A retrospective, monocentric study of all patients who underwent retrograde stenting of proximal IA and CCA stenosis via surgical cutdown of the CCA, with or without concomitant CEA, between 2016 and 2023 was performed. Results: Overall, 33 patients were treated. A total of 15 patients (45.5%) were male, with the mean age being 67 ± 9.1 years, and 58% (n = 19) of the patients presented with neurological symptoms. Open retrograde stenting was performed in 67% (n = 22) in ACC, and in 33% (n = 11) in IA stenosis. A total of 20 patients (61%) underwent retrograde stenting with synchronous ipsilateral CEA for concomitant stenosis of the carotid bifurcation. There was no 30-day mortality. The perioperative stroke rate was 3% (n = 1) with complete symptom recovery. During the follow up at 32 months (95% CI: 24–39), three late deaths (9.1%) and one symptomatic stent occlusion were observed and, in five patients (15.2%), re-intervention for restenosis was necessary. Conclusions: Open retrograde stenting for of proximal IA or CCA stenosis with or without CEA, in case of tandem carotid lesions, can be performed safely with a low rate of early adverse events. Continuous follow up examinations are necessary due to relevant instent re-stenosis rates.https://www.mdpi.com/2075-4426/14/3/223carotid endarterectomycarotid stentinghybrid carotid procedurestandem carotid lesionsretrograde carotid stenting |
| spellingShingle | Marvin Kapalla Albert Busch Steffen Wolk Christian Reeps Open Retrograde Stenting of Proximal Innominate and Common Carotid Artery Stenosis Journal of Personalized Medicine carotid endarterectomy carotid stenting hybrid carotid procedures tandem carotid lesions retrograde carotid stenting |
| title | Open Retrograde Stenting of Proximal Innominate and Common Carotid Artery Stenosis |
| title_full | Open Retrograde Stenting of Proximal Innominate and Common Carotid Artery Stenosis |
| title_fullStr | Open Retrograde Stenting of Proximal Innominate and Common Carotid Artery Stenosis |
| title_full_unstemmed | Open Retrograde Stenting of Proximal Innominate and Common Carotid Artery Stenosis |
| title_short | Open Retrograde Stenting of Proximal Innominate and Common Carotid Artery Stenosis |
| title_sort | open retrograde stenting of proximal innominate and common carotid artery stenosis |
| topic | carotid endarterectomy carotid stenting hybrid carotid procedures tandem carotid lesions retrograde carotid stenting |
| url | https://www.mdpi.com/2075-4426/14/3/223 |
| work_keys_str_mv | AT marvinkapalla openretrogradestentingofproximalinnominateandcommoncarotidarterystenosis AT albertbusch openretrogradestentingofproximalinnominateandcommoncarotidarterystenosis AT steffenwolk openretrogradestentingofproximalinnominateandcommoncarotidarterystenosis AT christianreeps openretrogradestentingofproximalinnominateandcommoncarotidarterystenosis |