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OtherINTERVENTIONAL

Angioscopic Observation During Carotid Angioplasty with Stent Placement

Hiroshi Tanemura, Seiji Hatazaki, Fumio Asakura, Kenji Kawaguchi, Keita Kuraishi, Naoki Toma, Hiroshi Sakaida, Masayuki Maeda and Waro Taki
American Journal of Neuroradiology September 2005, 26 (8) 1943-1948;
Hiroshi Tanemura
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Seiji Hatazaki
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Fumio Asakura
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Kenji Kawaguchi
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Keita Kuraishi
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Naoki Toma
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Hiroshi Sakaida
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Masayuki Maeda
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Waro Taki
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Article Figures & Data

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  • Fig 1.
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    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.

  • Fig 2.
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    Fig 2.

    Angioscopic image of the internal carotid artery in case 16 clearly shows stent attachment to the wall.

  • Fig 3.
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    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).

  • Fig 4.
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    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.

Tables

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    TABLE 1:

    Clinical features of the patients

    Patient No./Sex/Age (y)Stenosis (%)SymptomOcclusion Time: Total/CAS/ASProtection DeviceIschemic Lesion*
    1/M/6870Minor stroke19 min 12 s/16 min 12 s/3 minPSYes
    2/M/7780Asymptomatic21 min 34 s/18 min 34 s/3 minPSYes
    3/M/5980Asymptomatic24 min 24 s/20 min 9s/4 min 15 sPSNo
    4/M/6770Asymptomatic16 min 8 s/10 min 40 s/5 min 28 sPSYes
    5/M/8395Minor stroke25 min/21 min/4 minPSYes
    6/M/7075Minor stroke15 min 47 s/13 min 2 s/2 min 45 sPSYes
    7/M/7370Asymptomatic19 min/14 min 8 s/4 min 52 sPS—
    8/M/7170Asymptomatic8 min 56 s/6 min 58 s/1 min 58 sPS, PAESNo
    9/M/7370Asymptomatic14 min 2 s/9 min 57 s/4 min 5 sPSNo
    10/M/7760Minor stroke11 min 30 s/11 min/30 sPSYes
    11/M/7470Minor stroke17 min 47 s/14 min 47 s/3 minPSNo
    12/M/5470Asymptomatic11 min 10 s/9 min 10 s/2 minPSNo
    13/M/6990Asymptomatic23 min 1 s/16 min 4 s/6 min 57 sPAESNo
    14/M/7680Minor stroke13 min/10 min/3 minPAESNo
    15/M/6190Asymptomatic18 min 20 s/13 min 50 s/4 min 30sPAESNo
    16/M/6370Major stroke15 min 39 s/10 min 24 s/5 min 15 sPAESYes
    17/M/6570Asymptomatic14 min 6 s/8 min 37 s/5 min 29 sPAESYes
    18/M/7260Asymptomatic13 min 47 s/11 min/2 min 47 sPSNo
    Avg 707416 min 48 s/13 min 5 s/3 min 43s
    • Note.—CAS indicates carotid angioplasty with stent; AS, angioscopy; PS, PercuSurge; PAES, Parodi antiemboli system.

    • * Refers to asymptomatic ischemic lesions detected by diffusion-weighted MRI after the procedure.

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    TABLE 2:

    Angioscopic findings in the patients

    Patient No.Angioscopic Findings
    1Stent attachment to the wall
    2Intimal flap
    3Plaque protrusion
    4Stent attachment to the wall
    5Unclear view
    6Unclear view
    7Plaque protrusion, debris detaching form the plaque
    8Stent attachment to the wall
    9Stent attachment to the wall
    10Unclear view
    11Stent attachment to the wall
    12Unclear view
    13Stent attachment to the wall
    14Unclear view
    15Yellowish surface of carotid artery
    16Stent attachment to the wall, plaque protrusion
    17Unclear view
    18Stent attachment to the wall
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American Journal of Neuroradiology: 26 (8)
American Journal of Neuroradiology
Vol. 26, Issue 8
1 Sep 2005
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Angioscopic Observation During Carotid Angioplasty with Stent Placement
Hiroshi Tanemura, Seiji Hatazaki, Fumio Asakura, Kenji Kawaguchi, Keita Kuraishi, Naoki Toma, Hiroshi Sakaida, Masayuki Maeda, Waro Taki
American Journal of Neuroradiology Sep 2005, 26 (8) 1943-1948;

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Angioscopic Observation During Carotid Angioplasty with Stent Placement
Hiroshi Tanemura, Seiji Hatazaki, Fumio Asakura, Kenji Kawaguchi, Keita Kuraishi, Naoki Toma, Hiroshi Sakaida, Masayuki Maeda, Waro Taki
American Journal of Neuroradiology Sep 2005, 26 (8) 1943-1948;
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    • Detection of Ischemic Lesions by MR Imaging
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