Purpose. Perioperative cerebral microembolization demonstrated on diffusion-weighted MRI (DWI) can occur following carotid endarterectomy (CEA) and carotid artery stenting (CAS). We sought to explore potential risk factors for this in the large patient cohort. Methods. We reviewed a 6-year consecutive patient cohort that received either CEA or CAS, and perioperative DWI evaluations. Results. 303 patients were reviewed, and 56 (19.4&#x25;) patients were found to have perioperative microemboli. The incidence was higher among patients who received CAS (P &#x3c; 0.001). Hypertension (P = 0.03), smoking (P = 0.001), and a history of transient ischemic attacks (P = 0.04) were risk factors for microembolization. The risk was higher among CEA patients with obesity (P = 0.05), and among CAS patients with coronary artery disease (P = 0.03). Conclusion. Specific patient populations are likely more prone to develop perioperative cerebral microemboli following carotid intervention. Continued risk stratification may help decrease future perioperative cerebral microembolization rates.

Mohamed A. Zayed

Elizabeth Hitchner

Simin Gholibeikian

Allyson Rosen

Barton Lane

Wei Zhou

Patient Characteristics Can Influence the Incidence of Perioperative Microemboli during Carotid Artery Interventions

Articles describe a retrospective cohort study to assess the feasibility of reducing neointimal hyperplasia following interventions in chronic total occlusive peripheral vascular disease. The &#x201C;sandwich&#x201D; technique implemented is a novel modified angioplasty technique that combines heparin-bonded (Viabahn) stents with drug-eluting stents (Zilver PTX) deployed during arterial recanalisation. A review of 46 cases underwent this procedure at our institution as a limb saving procedure is conducted to determine mid-long-term patency outcomes and identify any subsequent interventions. Followup demonstrates favourable mid-long-term patency in 50&#x25; of TASC-C cases. No documented postprocedural complications were noted with unrelated observed mortality rates in either TASC-C or TASC-D subgroups. An observed advantage could be gained by using this new stenting technique via the subintimal recanalisation route. Albeit not statistically significant, type II diabetics and patients on aspiring had better sustained patency angioplasties. The sandwich technique has been shown to effectively offer symptoms relief and reduce total duration of hospital stay. Study findings support the need to evaluate the long-term efficacy through a larger longitudinal prospective study. However, to overcome the encountered study limitations, a well-structured methodology for comparison with conventional angioplasty techniques is essential to assess the synergetic potential of the sandwich technique.

Amir Awwad

Waleed Al-Obaydi

Yao Pey Yong

Said B. Habib

Heparin-Bonded Viabahn and Drug-Eluting Bare Metal Zilver (PTX) Sandwich Stents in Femoral Chronic Total Occlusion: A Retrospective Review of Mid-Term and Long-Term Outcomes

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Journal of Angiology

Table of Contents

Table of Contents: 2015

Patient Characteristics Can Influence the Incidence of Perioperative Microemboli during Carotid Artery Interventions

Heparin-Bonded Viabahn and Drug-Eluting Bare Metal Zilver (PTX) Sandwich Stents in Femoral Chronic Total Occlusion: A Retrospective Review of Mid-Term and Long-Term Outcomes