The clinical results of transcervical carotid artery stenting and frequency chosen as the approach route of carotid artery stenting in 1,067 consecutive cases
- Yoshikazu MatsudaAffiliated withDepartment of Neurosurgery, Japanese Red Cross Society Wakayama Medical Center Email author
- , Tomoaki TeradaAffiliated withDepartment of Neurosurgery, Wakayama Rosai Hospital
- , Osamu MasuoAffiliated withDepartment of Neurosurgery, Wakayama Medical University
- , Hiroyuki MatsumotoAffiliated withDepartment of Neurosurgery, Kishiwada Tokushukai Hospital
- , Kousuke OhshimaAffiliated withDepartment of Neurosurgery, Ishioka Cardiovascular and Neurosurgical Hospital
- , Tomoyuki TsumotoAffiliated withDepartment of Neuroendovascular Treatment, Kyusyu Medical Center
- , Mitsuharu TsuuraAffiliated withDepartment of Neurosurgery, Japanese Red Cross Society Wakayama Medical Center
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Carotid artery stenting (CAS) is generally performed via a transfemoral approach. A transbrachial approach is usually chosen as an alternative when CAS via a transfemoral approach is difficult. At our institutions, a transcervical approach is chosen when the previous two approach routes are not available. We reviewed CAS cases treated via the transcervical route in our 1,067 CAS series to investigate the safety, feasibility, and frequency of this procedure as an approach route of CAS.
We performed 1,067 CAS procedures in 1,067 consecutive cases between December 2002 and June 2011. Initially, a transfemoral route was chosen, and secondarily a transbrachial route, the last choice was a transcervical route. A transbrachial approach was chosen in 96 (9.0 %) cases and a transcervical approach in ten (0.9 %). We reviewed the characteristics and outcomes of CAS performed via a transcervical approach.
CAS was successfully performed on all ten transcervical-approach patients. Eight procedures were performed under local anesthesia and two under general anesthesia. Perioperative morbidity and mortality were both 0 %. The modified Rankin scale (mRS) showed no deterioration at 3 months except for one case whose mRS became five because of an embolic stroke after aortic valve replacement.
CAS via a transcervical approach was safe and feasible, and its frequency chosen as an approach route was 0.9 %. This procedure can be an alternative to transfemoral or transbrachial approaches when CAS via either of these approaches is too difficult.
KeywordsTranscervical approach CAS Local anesthesia Alternative therapy
- The clinical results of transcervical carotid artery stenting and frequency chosen as the approach route of carotid artery stenting in 1,067 consecutive cases
Volume 155, Issue 8 , pp 1575-1581
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- Springer Vienna
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- Transcervical approach
- Local anesthesia
- Alternative therapy
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- 1. Department of Neurosurgery, Japanese Red Cross Society Wakayama Medical Center, 20-banchi, 4-chome, Komatsubara-dori, Wakayama city, Wakayama, Japan, 640-8558
- 2. Department of Neurosurgery, Wakayama Rosai Hospital, Wakayama City, Japan
- 3. Department of Neurosurgery, Wakayama Medical University, Wakayama City, Japan
- 4. Department of Neurosurgery, Kishiwada Tokushukai Hospital, Kishiwada City, Japan
- 5. Department of Neurosurgery, Ishioka Cardiovascular and Neurosurgical Hospital, Ishioka City, Japan
- 6. Department of Neuroendovascular Treatment, Kyusyu Medical Center, Fukuoka city, Japan