Publication:
Relevance of distal arterial collapse in stenting of atherosclerotic near-occlusion of the carotid artery

dc.contributor.coauthorÇay, Ferdi
dc.contributor.coauthorBalcı, Sinan
dc.contributor.coauthorArsava, Ethem Murat
dc.contributor.coauthorTopçuoğlu, M. A.
dc.contributor.coauthorArat, Anıl
dc.contributor.departmentSchool of Medicine
dc.contributor.kuauthorÇil, Barbaros Erhan
dc.contributor.schoolcollegeinstituteSCHOOL OF MEDICINE
dc.date.accessioned2024-11-09T23:25:05Z
dc.date.issued2020
dc.description.abstractBACKGROUND and PURPOSE: Carotid near-occlusion has been subclassified into near-occlusion with and without collapse. We aimed to compare the technical success and perioperative complication rates of carotid artery stent placement with special attention to these subtypes to see whether there is a clinical relevance of this subclassification. MATERIALS and METHODS: From January 2014 to January 2018, we retrospectively evaluated all patients with atherosclerotic extracranial carotid stenosis treated by carotid artery stent placement. Patients with near-occlusion were identified based on DSA findings. Patient characteristics, the presence of criteria for near-occlusion and collapse, arterial diameters, technical success rate, and perioperative (?30 days) complications were analyzed. RESULTS: We identified 59 near-occlusions in 58 (46 men, 11 with collapse) patients. Forty-one patients (70.7%) were symptomatic. Technical success rate was 98.3% (58 of 59 procedures). In 1 case of near-occlusion with collapse, we were not able to pass through the stenosis. Compared with patients without collapse (4.2% of 48 cases), those with collapse (30% of 10 stented patients) had significantly higher rates of postintervention hyperperfusion syndrome (P = .032). In the whole cohort, the permanent morbidity and mortality rate was 3.4% (1.7% permanent morbidity and 1.7% mortality). For asymptomatic and symptomatic near-occlusion groups, the rates were 0% and 4.9%, respectively. The composite risk of stroke, death, and myocardial infarction was similar between the groups with and without collapse (P = .682). Rate of hyperperfusion syndrome (with or without permanent deficit) was similar (P = 1) in preoperatively symptomatic patients versus asymptomatic patients (9.8% vs 5.9%). Internal carotid artery diameter consistently increased after carotid artery stent placement in patients with collapse and was not related to the development of hyperperfusion syndrome. CONCLUSIONS: Care should be taken to minimize hyperperfusion risk in patients with near-occlusion undergoing CAS, especially in the subgroup of patients with collapse and in patients with both symptomatic and asymptomatic carotid stenosis.
dc.description.indexedbyWOS
dc.description.indexedbyScopus
dc.description.indexedbyPubMed
dc.description.issue6
dc.description.openaccessYES
dc.description.publisherscopeInternational
dc.description.sponsoredbyTubitakEuN/A
dc.description.volume41
dc.identifier.doi10.3174/ajnr.A6570
dc.identifier.eissn1936-959X
dc.identifier.issn0195-6108
dc.identifier.quartileQ2
dc.identifier.scopus2-s2.0-85086346168
dc.identifier.urihttps://doi.org/10.3174/ajnr.A6570
dc.identifier.urihttps://hdl.handle.net/20.500.14288/11314
dc.identifier.wos548058500028
dc.keywordsCerebral hyperfusion syndrome
dc.keywordsIntracranial hemorrhage
dc.keywordsEndovascular treatment
dc.keywordsPseudo-occlusion
dc.language.isoeng
dc.publisherAmer Soc Neuroradiology
dc.relation.ispartofAmerican Journal of Neuroradiology
dc.subjectClinical neurology
dc.subjectNeuroimaging
dc.subjectRadiology, Nuclear medicine
dc.subjectMedical imaging
dc.titleRelevance of distal arterial collapse in stenting of atherosclerotic near-occlusion of the carotid artery
dc.typeJournal Article
dspace.entity.typePublication
local.contributor.kuauthorÇil, Barbaros Erhan
local.publication.orgunit1SCHOOL OF MEDICINE
local.publication.orgunit2School of Medicine
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