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AJNR - American Journal of Neuroradiology

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Angioscopic Observation During Carotid Angioplasty with Stent Placement

Hiroshi Tanemura^a, Seiji Hatazaki^a, Fumio Asakura^a, Kenji Kawaguchi^a, Keita Kuraishi^a, Naoki Toma^a, Hiroshi Sakaida^a, Masayuki Maeda^b and Waro Taki^a

^a Department of Neurosurgery, Mie University Medical School, 2-174 Edobashi, Tsu, Mie 514-507, Japan
^b Department of Radiology, Mie University Medical School, 2-174 Edobashi, Tsu, Mie 514-507, Japan

View larger version (33K): [in a new window]   FIG 1. Angioscopic observation with distal protection (A) with PercuSurge GuardWire and (B) with the Parodi Antiemboli System. CCA signifies common carotid artery; ICA, internal carotid artery; ECA, external carotid artery; PS, PercuSurge GuardWire; FC, fiber catheter AS-003 with aspiration catheter; PAES, Parodi Antiemboli System.

View larger version (74K): [in a new window]   FIG 2. Angioscopic image of the internal carotid artery in case 16 clearly shows stent attachment to the wall.

View larger version (40K): [in a new window]   FIG 3. Angioscopic image of the internal carotid artery in case 7. First debris (red arrowheads) detaches from the atherosclerotic carotid wall and then floats to the distal side with time (A–E). Next debris (yellow arrowheads) also detaches from the carotid wall (D–F).

View larger version (63K): [in a new window]   FIG 4. Angioscopic image of the internal carotid artery proximal to the stent in case 2 shows the intimal flap (arrows) fluttering from the arterial wall.