Novel Application of Transcarotid Artery Stenting With Dynamic Flow Reversal for Treatment of Symptomatic Tandem Carotid Artery Lesions Via an Ascending Aorta to Common Carotid Artery Bypass Graft

Nikunj N. Donde, S. Keisin Wang, Jane L. Liao, Andres C. Fajardo, Phillip Hess, Raghu Motaganahalli

Research output: Contribution to journalArticle

Abstract

The treatment of patients with symptomatic tandem lesions of their carotid artery is challenging. One solution is carotid endarterectomy with retrograde ipsilateral proximal endovascular intervention, but it is associated with a higher postoperative risk of stroke. Unfortunately, symptomatic patients with tandem lesions often present with stenotic, calcified supra-aortic arch vessels and require multiple modalities to adequately revascularize including staged approaches or hybrid procedures. Herein, we report the successful treatment of a symptomatic 76-year-old female with a calcific severe stenosis of her innominate artery treated by a prosthetic bypass graft from her ascending aorta to proximal common carotid artery, interval ligation, and use of TransCarotid artery revascularization with reverse-flow to treat her proximal internal carotid artery stenosis via this bypass graft.

Original languageEnglish (US)
JournalVascular and Endovascular Surgery
DOIs
StateAccepted/In press - Jan 1 2019

Fingerprint

Common Carotid Artery
Carotid Arteries
Aorta
Arteries
Brachiocephalic Trunk
Transplants
Carotid Endarterectomy
Carotid Stenosis
Thoracic Aorta
Ligation
Pathologic Constriction
Stroke
Therapeutics

Keywords

  • bypass
  • carotid stenosis
  • graft
  • tandem lesion
  • tandem revascularization
  • TCAR

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

Cite this

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title = "Novel Application of Transcarotid Artery Stenting With Dynamic Flow Reversal for Treatment of Symptomatic Tandem Carotid Artery Lesions Via an Ascending Aorta to Common Carotid Artery Bypass Graft",
abstract = "The treatment of patients with symptomatic tandem lesions of their carotid artery is challenging. One solution is carotid endarterectomy with retrograde ipsilateral proximal endovascular intervention, but it is associated with a higher postoperative risk of stroke. Unfortunately, symptomatic patients with tandem lesions often present with stenotic, calcified supra-aortic arch vessels and require multiple modalities to adequately revascularize including staged approaches or hybrid procedures. Herein, we report the successful treatment of a symptomatic 76-year-old female with a calcific severe stenosis of her innominate artery treated by a prosthetic bypass graft from her ascending aorta to proximal common carotid artery, interval ligation, and use of TransCarotid artery revascularization with reverse-flow to treat her proximal internal carotid artery stenosis via this bypass graft.",
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author = "Donde, {Nikunj N.} and Wang, {S. Keisin} and Liao, {Jane L.} and Fajardo, {Andres C.} and Phillip Hess and Raghu Motaganahalli",
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AU - Donde, Nikunj N.

AU - Wang, S. Keisin

AU - Liao, Jane L.

AU - Fajardo, Andres C.

AU - Hess, Phillip

AU - Motaganahalli, Raghu

PY - 2019/1/1

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N2 - The treatment of patients with symptomatic tandem lesions of their carotid artery is challenging. One solution is carotid endarterectomy with retrograde ipsilateral proximal endovascular intervention, but it is associated with a higher postoperative risk of stroke. Unfortunately, symptomatic patients with tandem lesions often present with stenotic, calcified supra-aortic arch vessels and require multiple modalities to adequately revascularize including staged approaches or hybrid procedures. Herein, we report the successful treatment of a symptomatic 76-year-old female with a calcific severe stenosis of her innominate artery treated by a prosthetic bypass graft from her ascending aorta to proximal common carotid artery, interval ligation, and use of TransCarotid artery revascularization with reverse-flow to treat her proximal internal carotid artery stenosis via this bypass graft.

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KW - tandem revascularization

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