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Chapters (10)
Description
Shooting date : 2017-09-28
Last update : 2018-06-08
Language(s) : English
Views : 16485


Left Internal Carotid Artery Occlusion with Progressive Right Internal Carotid Artery Stenosis


This 18 minutes didactic reco...


Left Internal Carotid Artery Occlusion with Progressive Right Internal Carotid Artery Stenosis


This 18 minutes didactic recorded procedure concerns a 68 years male with coronary insufficiency and carotid lesions. He presents an occluded left internal carotid artery associated with a severe ulcerated worsening right internal carotid stenosis.
This complex stenosis was treated by new micromesh carotid stent under carotid protection by filter . Watch this informative procedure on how to treat patients with multiple carotid lesions.

Step-by-Step Procedure

  • Femoral access for carotid angioplasty
  • Common carotid access in tortuous aorta
  • Analysis of carotid lesion by selective angiography
  • Placement of filter as embolic protecting device
  • Pre-dilatation and artery preparation before carotid artery stenting
  • Placement of braided micromesh stent Roadsaver
  • Post Stenting dilatation and analysis of results
  • Filter retrieval and evaluation of carotid circulation  

Learning points

  • How to access from groin the brachio-cephalic trunk in a tortuous aorta
  • The use of two guidewires to access common carotid
  • Placement of filter in a tortuous carotid artery
  • Predilatation and preparation of carotid lesion before stenting
  • Accurate placement of new micromesh carotid stent
  • Cardiac monitoring during carotid stenting

Bibliography

 

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  • arie B. 'ישא 'שד איק ןמגןבשאןםמ שדטצפאםצשאןב פשאןקמא 'ןאי ךקדד איקמ 50% דאקמםדןד?.

    • Max A. dont understand . Sorry

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  • AWADHESH D. Nice

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  • Zambonialbe A. Very interesting case !

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    • Alexander P. super

      • Max A. Thank you

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    • Chun-Yuan C. Will direct stenting be another choice ?

      • Max A. Sorry for the delay .
        I recommend to predilate for this micromesh Stent to be sure to have an harmonious deployment to easen the crossing . It is particularly important with the CGuard stent

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    • Milan M. Nice example! According to your experience, how do the Micromash Stents behave in highly calcified lesions? Thank You

      • Max A. In very calcified lesions it is indispensable to prepare the lesion by a pre-dilatation in order to be sure that the residual stenosis is not Severe .

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    • Mohammed R. Good

      • Max A. Thank You

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    • Maher J. Perfect job

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      • Maher J. Nice job

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