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E-107 Carotid artery stenting in patients with symptomatic non-stenotic carotid artery disease - a case series
ConclusionsIn this case series performed over a 10-year period at a high-volume stroke center we show that CAS is safe and efficient in patients with SyNC. Previous studies have established safety and effectiveness of CES in patients presenting with SyNC, however there is a paucity of reports in the literature regarding the effect of CAS in this patient population. Recent guidelines have brought specific attention to high-risk plaque characteristics which suggest that plaque instability plays a major role in the onset of ischemic events, regardless of lumen narrowing. Advanced imaging techniques, such as Optical Coherence ...
Source: Journal of NeuroInterventional Surgery - July 30, 2023 Category: Neurosurgery Authors: Nedelcu, S., Kuhn, A., Singh, J., Puri, A. Tags: SNIS 20th annual meeting electronic poster abstracts Source Type: research

Carotid web leads to new thrombus formation: computational fluid dynamic analysis coupled with histological evidence
We describe a 48-year-old woman with carotid web who developed embolic stroke. We obtained a fresh thrombus from the internal carotid artery when carotid endarterectomy was performed. A preoperative computational fluid dynamics (CFD) study showed stagnation of blood around the web structure as well as the low wall shear stress. The rheological analysis newly disclosed mechanisms of thrombus formation related to the carotid web. CFD study in the carotid web may determine indication and timing of surgical interventions with further accumulation of clinical evidence.
Source: Acta Neurochirurgica - March 9, 2020 Category: Neurosurgery Source Type: research

Combined interventional and surgical treatment of tandem middle cerebral artery embolus and internal carotid artery occlusion: case report.
Abstract Tandem internal carotid artery (ICA) origin occlusion and middle cerebral artery (MCA) thromboembolism is a life-threatening condition with poor neurological outcome. The authors report on a patient presenting with acute ischemic stroke from a tandem ICA and MCA occlusion with penumbra. Emergency MCA mechanical thrombectomy was performed through percutaneous cervical ICA access due to the inability to cross the cervical carotid occlusion. Emergency carotid endarterectomy to reperfuse the poorly collateralized hemisphere and repair the ICA access site was performed 2 hours after completion of tissue plasmi...
Source: Journal of Neurosurgery - November 17, 2017 Category: Neurosurgery Authors: Frenkel MB, Renfrow JJ, Singh J, Garg N, Wolfe SQ Tags: J Neurosurg Source Type: research

Acute Stroke After Carotid Endarterectomy: Time for a Paradigm Shift? Multicenter Experience With Emergent Carotid Artery Stenting With or Without Intracranial Tandem Occlusion Thrombectomy
CONCLUSION: Emergent endovascular evaluation in the setting of acute post--carotid endarterectomy thrombosis is a safe and timely treatment option, with the benefit of detecting and treating embolic intracranial lesions. Immediate angiography and intervention in this rare surgical complication show promising initial results. ABBREVIATIONS: CAS, carotid artery stenting CEA, carotid endarterectomy ICA, internal carotid artery NASCET, North American Symptomatic Carotid Endarterectomy Trial
Source: Neurosurgery - March 19, 2015 Category: Neurosurgery Tags: Research-Human-Clinical Studies Source Type: research

Emergent intracranial surgical embolectomy in conjunction with carotid endarterectomy for acute internal carotid artery terminus embolic occlusion and tandem occlusion of the cervical carotid artery due to plaque rupture.
Abstract Acute internal carotid artery (ICA) terminus occlusion is associated with extremely poor functional outcomes or mortality, especially when it is caused by plaque rupture of the cervical ICA with engrafted thrombus that elongates and extends into the ICA terminus. The goal of this study was to evaluate the efficacy and safety of surgical embolectomy in conjunction with carotid endarterectomy (CEA) for acute ICA terminus occlusion associated with cervical plaque rupture resulting in tandem occlusion. A retrospective review of medical records was performed. Clinical and radiographic characteristics were eval...
Source: Journal of Neurosurgery - January 9, 2015 Category: Neurosurgery Authors: Hasegawa H, Inoue T, Tamura A, Saito I Tags: J Neurosurg Source Type: research

64-detector CT angiography within 24 hours after carotid endarterectomy and correlation with postoperative stroke.
CONCLUSIONS CTA within 24 hours of CEA demonstrates characteristic anatomical findings. CCA step-offs and ECA flaps are relatively common and clinically insignificant, whereas ICA/CCA flaps and thrombi are less frequently seen and are associated with postoperative stroke/TIA. PMID: 25555168 [PubMed - as supplied by publisher]
Source: Journal of Neurosurgery - January 2, 2015 Category: Neurosurgery Authors: Gallati CP, Jain M, Damania D, Kanthala AR, Jain AR, Koch GE, Kung NT, Wang HZ, Replogle RE, Jahromi BS Tags: J Neurosurg Source Type: research

P-020 Emergent Carotid Artery Stenting with or without Intracranial Tandem Occlusion Lesions Following Carotid Endarterectomy
Conclusion Emergent endovascular evaluation in the setting of acute post CEA thrombosis is a safe and timely treatment option, with the benefit of detecting and treating embolic intracranial lesions. More investigation is necessary to define the role of immediate angiography and intervention in this rare surgical complication. Abstract P-020 Table 1Patient demographics AgeGender% Carotid stenosisSymptomaticCase 166M90NCase 273M80–99YCase 378M70YCase 459F80–99YCase 555M80–99NCase 680MUnknownUnknown Abstract P-020 Table 2Pre procedural metrics Time from CEA to symptoms (hrs)Time from last normal to throm...
Source: Journal of NeuroInterventional Surgery - July 26, 2014 Category: Neurosurgery Authors: Vargas, J., Zuckerman, S., Chaudry, I., Turner, R., Turk, A., Spiotta, A. Tags: Oral poster abstracts Source Type: research