External carotid artery stenting to treat patients with symptomatic ipsilateral internal carotid artery occlusion: A multicenter case series

David S. Xu, Todd A. Abruzzo, Felipe C. Albuquerque, Guilherme Dabus, Mark K. Eskandari, Lee R. Guterman, Ziad A. Hage, Michael C. Hurley, Ricardo A. Hanel, Elad I. Levy, Christopher W. Nichols, Andrew J. Ringer, H. Hunt Batjer, Bernard R. Bendok

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

BACKGROUND: The external carotid artery (ECA) anastomoses in many distal territories supplied by the internal carotid artery (ICA) and is an important source of collateral circulation to the brain. Stenosis of the ECA in ipsilateral ICA occlusion can produce ischemic sequelae. OBJECTIVE: To examine the effectiveness of ECA stenting in treating symptomatic ipsilateral ICA occlusion. METHODS: We retrospectively reviewed patient databases from 5 academic medical centers to identify all individuals who underwent ECA stenting after 1998. For all discovered cases, coinvestigators used a common submission form to harvest relevant demographic information, clinical data, procedural details, and follow-up results for further analysis. RESULTS: Twelve patients (median age, 66 years; range, 45-79 years) were identified for our cohort. Vessel disease involvement included severe ECA stenosis ≥ 70% in 11 patients and ipsilateral ICA occlusion in all patients. Presenting symptoms included signs of transient ischemic attack, stroke, and amaurosis fugax. ECA stenting was associated with preservation of neurological status in 11 patients and resolution of symptoms in 5 patients at a median follow-up time of 26 months (range, 1-87 months; mean, 29 months). Symptomatic in-stent restenosis did not occur within any patient during the follow-up course. CONCLUSION: We found ECA stenting in symptomatic ipsilateral ICA disease to be a potentially effective strategy to preserve neurological function and to relieve ischemic symptoms. Further investigation with larger studies and longer follow-up periods is warranted to elucidate the true indications of this management strategy.

Original languageEnglish (US)
Pages (from-to)314-321
Number of pages8
JournalNeurosurgery
Volume67
Issue number2
DOIs
StatePublished - Aug 2010

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External Carotid Artery
Internal Carotid Artery
Carotid Stenosis
Amaurosis Fugax
Collateral Circulation
Carotid Artery Diseases
Transient Ischemic Attack
Signs and Symptoms
Stents
Stroke
Demography
Databases
Brain

Keywords

  • Angioplasty and stenting
  • Carotid endarterectomy
  • Endovascular treatment
  • External carotid artery

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Xu, D. S., Abruzzo, T. A., Albuquerque, F. C., Dabus, G., Eskandari, M. K., Guterman, L. R., ... Bendok, B. R. (2010). External carotid artery stenting to treat patients with symptomatic ipsilateral internal carotid artery occlusion: A multicenter case series. Neurosurgery, 67(2), 314-321. https://doi.org/10.1227/01.NEU.0000371728.49216.3B

External carotid artery stenting to treat patients with symptomatic ipsilateral internal carotid artery occlusion : A multicenter case series. / Xu, David S.; Abruzzo, Todd A.; Albuquerque, Felipe C.; Dabus, Guilherme; Eskandari, Mark K.; Guterman, Lee R.; Hage, Ziad A.; Hurley, Michael C.; Hanel, Ricardo A.; Levy, Elad I.; Nichols, Christopher W.; Ringer, Andrew J.; Batjer, H. Hunt; Bendok, Bernard R.

In: Neurosurgery, Vol. 67, No. 2, 08.2010, p. 314-321.

Research output: Contribution to journalArticle

Xu, DS, Abruzzo, TA, Albuquerque, FC, Dabus, G, Eskandari, MK, Guterman, LR, Hage, ZA, Hurley, MC, Hanel, RA, Levy, EI, Nichols, CW, Ringer, AJ, Batjer, HH & Bendok, BR 2010, 'External carotid artery stenting to treat patients with symptomatic ipsilateral internal carotid artery occlusion: A multicenter case series', Neurosurgery, vol. 67, no. 2, pp. 314-321. https://doi.org/10.1227/01.NEU.0000371728.49216.3B
Xu, David S. ; Abruzzo, Todd A. ; Albuquerque, Felipe C. ; Dabus, Guilherme ; Eskandari, Mark K. ; Guterman, Lee R. ; Hage, Ziad A. ; Hurley, Michael C. ; Hanel, Ricardo A. ; Levy, Elad I. ; Nichols, Christopher W. ; Ringer, Andrew J. ; Batjer, H. Hunt ; Bendok, Bernard R. / External carotid artery stenting to treat patients with symptomatic ipsilateral internal carotid artery occlusion : A multicenter case series. In: Neurosurgery. 2010 ; Vol. 67, No. 2. pp. 314-321.
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T1 - External carotid artery stenting to treat patients with symptomatic ipsilateral internal carotid artery occlusion

T2 - A multicenter case series

AU - Xu, David S.

AU - Abruzzo, Todd A.

AU - Albuquerque, Felipe C.

AU - Dabus, Guilherme

AU - Eskandari, Mark K.

AU - Guterman, Lee R.

AU - Hage, Ziad A.

AU - Hurley, Michael C.

AU - Hanel, Ricardo A.

AU - Levy, Elad I.

AU - Nichols, Christopher W.

AU - Ringer, Andrew J.

AU - Batjer, H. Hunt

AU - Bendok, Bernard R.

PY - 2010/8

Y1 - 2010/8

N2 - BACKGROUND: The external carotid artery (ECA) anastomoses in many distal territories supplied by the internal carotid artery (ICA) and is an important source of collateral circulation to the brain. Stenosis of the ECA in ipsilateral ICA occlusion can produce ischemic sequelae. OBJECTIVE: To examine the effectiveness of ECA stenting in treating symptomatic ipsilateral ICA occlusion. METHODS: We retrospectively reviewed patient databases from 5 academic medical centers to identify all individuals who underwent ECA stenting after 1998. For all discovered cases, coinvestigators used a common submission form to harvest relevant demographic information, clinical data, procedural details, and follow-up results for further analysis. RESULTS: Twelve patients (median age, 66 years; range, 45-79 years) were identified for our cohort. Vessel disease involvement included severe ECA stenosis ≥ 70% in 11 patients and ipsilateral ICA occlusion in all patients. Presenting symptoms included signs of transient ischemic attack, stroke, and amaurosis fugax. ECA stenting was associated with preservation of neurological status in 11 patients and resolution of symptoms in 5 patients at a median follow-up time of 26 months (range, 1-87 months; mean, 29 months). Symptomatic in-stent restenosis did not occur within any patient during the follow-up course. CONCLUSION: We found ECA stenting in symptomatic ipsilateral ICA disease to be a potentially effective strategy to preserve neurological function and to relieve ischemic symptoms. Further investigation with larger studies and longer follow-up periods is warranted to elucidate the true indications of this management strategy.

AB - BACKGROUND: The external carotid artery (ECA) anastomoses in many distal territories supplied by the internal carotid artery (ICA) and is an important source of collateral circulation to the brain. Stenosis of the ECA in ipsilateral ICA occlusion can produce ischemic sequelae. OBJECTIVE: To examine the effectiveness of ECA stenting in treating symptomatic ipsilateral ICA occlusion. METHODS: We retrospectively reviewed patient databases from 5 academic medical centers to identify all individuals who underwent ECA stenting after 1998. For all discovered cases, coinvestigators used a common submission form to harvest relevant demographic information, clinical data, procedural details, and follow-up results for further analysis. RESULTS: Twelve patients (median age, 66 years; range, 45-79 years) were identified for our cohort. Vessel disease involvement included severe ECA stenosis ≥ 70% in 11 patients and ipsilateral ICA occlusion in all patients. Presenting symptoms included signs of transient ischemic attack, stroke, and amaurosis fugax. ECA stenting was associated with preservation of neurological status in 11 patients and resolution of symptoms in 5 patients at a median follow-up time of 26 months (range, 1-87 months; mean, 29 months). Symptomatic in-stent restenosis did not occur within any patient during the follow-up course. CONCLUSION: We found ECA stenting in symptomatic ipsilateral ICA disease to be a potentially effective strategy to preserve neurological function and to relieve ischemic symptoms. Further investigation with larger studies and longer follow-up periods is warranted to elucidate the true indications of this management strategy.

KW - Angioplasty and stenting

KW - Carotid endarterectomy

KW - Endovascular treatment

KW - External carotid artery

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