المؤلفون: Hyun Jin Kim, Sanghyeon Kim, Myongjin Kang

المصدر: The Egyptian Journal of Neurology, Psychiatry and Neurosurgery, Vol 59, Iss 1, Pp 1-4 (2023)

مصطلحات موضوعية: Carotid stenosis, Angioplasty, Stent, Embolic protection device, Complication, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571

الوصف: Abstract Background Distal embolic protection devices have been widely used to reduce the incidence of embolic events during carotid artery stenting. Entrapment of an embolic protection device is an extremely rare complication, and most cases are resolved by surgical removal. Case presentation A 67-year-old male underwent carotid artery stenting with an embolic protection device. During the procedure, the embolic protection filter became entrapped within the stent. The complication was resolved endovascularly without sequelae. Conclusion The most important step in stenting is to be careful until the procedure is completed. However, if complications occur during the operation, in-depth knowledge of the catheters, wires, and devices will help the operator resolve the problem using endovascular techniques.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1687-8329Test

الوصول الحر: https://doaj.org/article/1a029ddda10c485b9f91eacc5c82204cTest

المؤلفون: Malcolm Han Wen Mak, MBBS, FRCSEd, Glenn Wei Leong Tan, MBChB, FRCSEd, Yi-Wei Wu, MD, FRCR, Lawrence Han Hwee Quek, BMBS, FRCR

المصدر: Journal of Vascular Surgery Cases and Innovative Techniques, Vol 9, Iss 4, Pp 101340- (2023)

مصطلحات موضوعية: Aortic thrombus, Endovascular stenting, Distal embolization, Embolic protection device, Wallstent, Surgery, RD1-811, Diseases of the circulatory (Cardiovascular) system, RC666-701

الوصف: Blue toe syndrome can occur due to distal embolization from proximal lesions such as an aortic thrombus. We describe the case of a patient who presented with chronic limb threatening ischemia due to a flow-limiting infrarenal aortic thrombus, with gangrene from distal embolization to the left fifth toe, and was successfully treated with endovascular aortic stent graft insertion. Distal embolization during instrumentation was successfully prevented by using a partially deployed Wallstent (Boston Scientific) as an embolic protection device. The reconstrainable Wallstent device can be considered for distal thromboembolic protection during aortic stenting, in particular, when distal embolization is a concern and commercial devices are not readily available.

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S2468428723002496Test; https://doaj.org/toc/2468-4287Test

الوصول الحر: https://doaj.org/article/1610c6ec74b44739a614ea8c8ecab511Test

المؤلفون: Yasuyuki Tatsuta, MD, Tatsuya Ogino, MD, Hideki Endo, MD, PhD, Suguru Sakurai, MD, Hirohiko Nakamura, MD, PhD

المصدر: Radiology Case Reports, Vol 18, Iss 6, Pp 2112-2115 (2023)

مصطلحات موضوعية: Balloon catheter, Carotid artery stenting, Complication, Embolic protection device, Endovascular treatment, Extension wire, Medical physics. Medical radiology. Nuclear medicine, R895-920

الوصف: Carotid artery stenting is a treatment option for patients with significant symptomatic or asymptomatic carotid artery stenosis. Although use of an embolic protection device during carotid artery stenting can prevent distal embolization, device retrieval after stenting can be difficult. In this report, during an embolic protection device retrieval, it was not possible to advance recapture catheters through the distal flare segment of the stent because the device wire would catch on the flare or become jammed between the flare and vessel wall. Then, an extension wire was connected to the end of the device and a 5.2-Fr JB2-type balloon catheter was advanced over the wire, which was able to pass through the stent. The use of a 5.2-Fr JB2-type balloon catheter to retrieve a trapped embolic protection device is feasible and effective if standard maneuvers fail.

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S1930043323001632Test; https://doaj.org/toc/1930-0433Test

الوصول الحر: https://doaj.org/article/8e557a5507e34b7781099a488b6cd19bTest

المؤلفون: Giuseppe Vadalà, Vincenzo Sucato, Francesco Costa, Fausto Castriota, Roberto Nerla, Giuseppe Roscitano, Antonio Giovanni Versace, Alfredo Ruggero Galassi, Antonio Micari

المصدر: Journal of Personalized Medicine, Vol 14, Iss 3, p 250 (2024)

مصطلحات موضوعية: carotid artery stenting (CAS) complications, acute carotid stent thrombosis, cerebral embolic protection device failure, plaque prolapse after carotid stenting, cerebral hyper perfusion Syndrome (CHS), radial access site complications, Medicine

الوصف: Aims: To describe through emblematic images rare but clinically relevant carotid artery stenting complications that occurred at two high-volume centres for carotid artery stenting (CAS). Background: CAS is an alternative to carotid endarterectomy (CEA) for the treatment of carotid artery stenosis in patients judged to be at high risk for CEA. CAS complications range between 1 and 9% and are higher in older patients complaining of neurological symptoms at the time of presentation. Besides periprocedural or early-after-procedure stroke, which remains the true Achilles’ heel of CAS, other dramatic complications might compromise the clinical outcomes of this procedure. Methods: Five infrequent complications, out of more than 1000 CAS performed in the years 2016–2021, have been described. Results: Among CAS complications, acute carotid stent thrombosis, rescue retrieval of a disconnected distal cerebral embolic protection device, plaque prolapse after carotid stenting, cerebral hyperperfusion syndrome (CHS), and radial artery long sheath entrapment requiring surgical intervention were found to account for 0.3% of the total number of procedures performed by operators with high CAS volume. Conclusions: Unusual CAS complications may infrequently occur, even in hands of expert operators. To know how to deal with such complications might help interventionalists to improve CAS performance.

وصف الملف: electronic resource

العلاقة: https://www.mdpi.com/2075-4426/14/3/250Test; https://doaj.org/toc/2075-4426Test

الوصول الحر: https://doaj.org/article/a0c9de78ed77456281a56d3114805b1dTest

المؤلفون: Parul Kodan, Sakshi Khurana, Amit Gulati, Amit Hooda

المصدر: Heart and Mind, Vol 7, Iss 3, Pp 132-136 (2023)

مصطلحات موضوعية: antiplatelet, antithrombotic, embolic protection device, embolization, stroke, transcatheter aortic valve replacement, Diseases of the circulatory (Cardiovascular) system, RC666-701

الوصف: Transcatheter aortic valve replacement (TAVR) has become the treatment option for symptomatic severe aortic stenosis patients across all risk profiles. Despite remarkable advancements in technology and operator experience, the occurrence of periprocedural stroke remains a significant concern, predominantly attributed to thromboembolic events in the immediate postprocedural period. To optimize patient outcomes, various strategies have been developed to minimize the risk of stroke, encompassing comprehensive preprocedural planning, effective management of comorbidities, utilization of cerebral embolic protection devices, and tailored medical therapy. This comprehensive review summarizes the currently available strategies for mitigating periprocedural stroke post-TAVR and provides insights into future directions.

وصف الملف: electronic resource

العلاقة: http://www.heartmindjournal.org/article.asp?issn=2468-6476;year=2023;volume=7;issue=3;spage=132;epage=136;aulast=KodanTest; https://doaj.org/toc/2468-6476Test; https://doaj.org/toc/2468-6484Test

الوصول الحر: https://doaj.org/article/3548c82b77b042db9ed613c5c363eea0Test

المؤلفون: Ardianto Nandiwardhana, MD, Eka Prasetya Budi Mulia, MD, David Nugraha, MD, Aldhi Pradana, MD, Iswanto Pratanu, MD

المصدر: Radiology Case Reports, Vol 17, Iss 12, Pp 4666-4670 (2022)

مصطلحات موضوعية: Saphenous vein graft, Percutaneous coronary intervention, Embolic protection device, Drug-eluting stent, Distal embolization, Coronary artery bypass, Medical physics. Medical radiology. Nuclear medicine, R895-920

الوصف: Saphenous vein grafts (SVGs) are commonly used in coronary artery bypass graft (CABG) surgery patients. However, SVGs are prone to degradation and occlusion, resulting in poor long-term patency. Percutaneous coronary intervention (PCI) for SVG has been one of the options to treat SVGs disease despite its challenges. Embolic protection device (EPD) use along with proper stent and medications are considered to minimize complications in this procedure. A 61-year-old man, with 4-vessel coronary artery bypass using SVGs and left internal mammary artery (LIMA) 11 years ago, presented with chest pain for more than 3 months. Coronary angiography showed severe stenosis of the SVG to PDA with two lesions, chronic total occlusion in SVG to OM and LIMA to LAD, with patent SVG to D1. He was admitted for elective PCI using drug-eluting stents and distal embolic filter. There were no problems observed, and the procedure was completed with successful stenting in SVG to PDA without any complications. The patient was discharged on dual-antiplatelet therapy along with his previous medication history. PCI is preferred over repeated CABG in high-risk patients, and EPD should be considered whenever technically possible to minimize the risk of distal embolization and thereby improve outcomes in SVG PCI.

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S1930043322007634Test; https://doaj.org/toc/1930-0433Test

الوصول الحر: https://doaj.org/article/2756cbc8da414eb583c6e0e0a447d6cbTest

المؤلفون: Paul Joon Koo Choi, Mahmood Kabeil, Pedro J.F. Neves, Sammy S. Siada, Emily A. Malgor, Donald L. Jacobs, Rafael D. Malgor

المصدر: Annals of Vascular Surgery - Brief Reports and Innovations, Vol 3, Iss 1, Pp 100157- (2023)

مصطلحات موضوعية: hybrid open and endovascular surgery, Stent-graft thrombosis, Aortoiliac occlusive disease, Surgical bypass, embolic protection device, Arteriotomy, Diseases of the circulatory (Cardiovascular) system, RC666-701, Surgery, RD1-811

الوصف: Purpose: To present two cases of complex juxtarenal aortoiliac occlusions with failed previous aortic open and endovascular interventions, treated via aortoiliac endovascular recanalization due to presentation of chronic limb threatening ischemia. Case description: Case 1: A 67-year-old Caucasian male former smoker with multiple severe cardiac and pulmonary comorbidities presented with bilateral lower extremity ischemic rest pain. He had a history of prior open abdominal aortic aneurysm (AAA) repair with a tube graft that was acutely complicated and required two common iliac interventions with stents at an outside hospital but which re-thrombosed within a few months. He presented to us with a history of two years of physical limitations and an aortoiliac occlusion that was flush to the renal arteries. Endovascular recanalization of the infrarenal aorta, bilateral iliac arteries, and previous stents was achieved successfully with a complex crossing technique and a combination of covered and bare-metal stents. On a 36-month follow-up, he remained free of claudication, with palpable pedal pulses bilaterally. Case 2: A 64-year-old Caucasian male former smoker, with multiple cardiovascular and metabolic comorbidities presented with a painful non-healing ulcer on the left fourth toe and signs of sepsis. He had a history of aortoiliac occlusive disease and multiple prior endovascular revascularizations. Computed tomography angiogram (CTA) showed chronically occluded iliac artery stents as well as bilateral occlusions of the common and external iliac arteries. In addition, his left superficial femoral artery was occluded at the level of the adductor hiatus with significant collaterals reconstituting the popliteal artery. A diagnosis of acute, focal osteomyelitis secondary to complex vascular occlusion was made. A decision to pursue incision and drainage of the foot abscess followed by hybrid left lower extremity revascularization was made. An open left femoral endarterectomy with bovine patch angioplasty and endovascular recanalization of the left aortoiliac system by relining with stent-grafts was performed along with an amputation of his left fourth toe. On 6-month follow-up, he remained symptom-free with improved ankle-brachial index (ABI) and almost fully healed left foot. Conclusion: Although challenging, total percutaneous or hybrid approach for management of complex juxtarenal total aortoiliac occlusions with previously failed covered-stents or open aortic repair can be done successfully with extensive preoperative planning and carefully selected patients.

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S2772687822001179Test; https://doaj.org/toc/2772-6878Test

الوصول الحر: https://doaj.org/article/3e58968f5f844751be7a7c4dc18bd293Test

المؤلفون: Alessandro Fiocco, Andrea Colli, Laura Besola

المصدر: Frontiers in Cardiovascular Medicine, Vol 10 (2023)

مصطلحات موضوعية: valve endocarditis, AngioVac System, TriGuard embolic protection device, minimally invasive, transapical access, prosthesis endocarditis, Diseases of the circulatory (Cardiovascular) system, RC666-701

الوصف: The AngioVac System (AngioDynamics, Latham, NY) was developed for the treatment of right-sided heart and intravenous masses. Lately, it has been employed to deal with left-sided heart masses, in particular, native valve endocarditis (NVE) and valve prostheses endocarditis (VPE) in high-risk patients. Left-sided heart endocarditis has a high morbidity, and it also has a high mortality when open heart surgery is performed. Recently, patients presenting with left NVE and VPE have been treated with the off-label use of the AngioVac System even if the solution presents a considerable cerebral embolization risk issue due to the risk of fragmentation rather than a complete en-bloc aspiration of the masses. A percutaneous cerebral embolism protection system is currently used in TAVI procedures, especially when the native valve presents extensive calcifications and consequent significant embolic risks. We hereby present a clinical case series of a combined utilization of the AngioVac System and cerebral embolism protection system Triguard (Keystone Heart Ltd., Herzliya, Israel) to treat left NVE and VPE in prohibitive-surgical-risk patients.

وصف الملف: electronic resource

العلاقة: https://www.frontiersin.org/articles/10.3389/fcvm.2023.1121488/fullTest; https://doaj.org/toc/2297-055XTest

الوصول الحر: https://doaj.org/article/3b45e3b0d2c8462eb04437079e45a526Test

المؤلفون: Daal, Sayonara M, Jimenez-Rodriguez, Gian M J, Voskuil, Michiel, Kraaijeveld, Adriaan O, Dessing, Thomas C, Ramjankhan, Faiz Z, Mokhles, Mostafa M, Stella, Pieter R

المساهمون: Onderzoek CTC, Circulatory Health, Team Medisch, CTC

مصطلحات موضوعية: Cerebral embolic protection device, Stroke prevention, Transcatheter aortic valve replacement, TriGUARD 3, Cardiology and Cardiovascular Medicine, Journal Article

الوصف: OBJECTIVE: Periprocedural stroke during transcatheter aortic valve replacement (TAVR) is a highly feared adverse event. The TriGUARD 3 cerebral embolic protection device (CEPD) may have the potential benefit of reduction of embolic events, but it still remains unclear whether it reduces the incidence of periprocedural stroke or transient ischemic attack (TIA). We aimed to investigate whether the latest TriGUARD 3 CEPD reduces the incidence of clinically overt stroke within 72 h or at discharge after TAVR. METHODS: In this prospective single-center study 117 patients (mean age 80.3 years, 53.8 % male) were included from July 2020 to December 2021. RESULTS: The primary efficacy endpoint of this study, periprocedural clinically overt stroke or TIA, within 72 h or at discharge after TAVR with the TriGUARD 3 CEPD occurred in 1/117 pts (0.8 %). Secondary endpoints (device related issues such as life-threatening or disabling bleeding, acute kidney injury, major vascular complications) were reported in 4/117 pts (3.4 %). CONCLUSIONS: This study suggests that the use of the latest TriGUARD 3™ CEPD in transfemoral TAVR seems to be associated with a low rate of clinically overt stroke and a low rate of device related adverse events, reflecting "real world" TAVR practice. However these results should be hypothesis generating and confirmed in a large RCT.

وصف الملف: application/pdf

العلاقة: https://dspace.library.uu.nl/handle/1874/448526Test

الإتاحة: https://dspace.library.uu.nl/handle/1874/448526Test

المؤلفون: Joseph B. Alsberge, H. Richard McDonald

المصدر: American Journal of Ophthalmology Case Reports, Vol 28, Iss , Pp 101704- (2022)

مصطلحات موضوعية: Carotid artery stenting, Filter embolic protection device, Optical coherence tomography, Paracentral acute middle maculopathy, Retinal capillary ischemia, Ophthalmology, RE1-994

الوصف: Purpose: To report a case of paracentral acute middle maculopathy (PAMM) that presented after internal carotid artery stenting despite the use of a filter embolic protection device. Observations: A 74-year-old man presented one week following transfemoral stenting of the right internal carotid artery for high-grade stenosis. A filter-type embolic protection device was used during the stenting procedure to prevent distal embolization of atherosclerotic debris. Dilated examination of the right eye revealed a parafoveal gray lesion in the macula and optical coherence tomography showed a corresponding placoid hyperreflective band at the level of the inner nuclear layer consistent with PAMM. The patient was asymptomatic. At 10 weeks follow up the PAMM lesion was resolved. Conclusions: PAMM occurred following internal carotid artery stenting despite the use of a filter embolic protection device, likely due to embolic debris passing through the filter device or debris released while the filter was in a collapsed state. The PAMM lesion was small and resolved without visual sequelae.

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S2451993622004509Test; https://doaj.org/toc/2451-9936Test

الوصول الحر: https://doaj.org/article/fce47936ae97435191e05730b90ed0a4Test