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Neuroradiology

, Volume 52, Issue 9, pp 831–836 | Cite as

Fragmentation of calcified plaque after carotid artery stenting in heavily calcified circumferential stenosis

  • Masanori Tsutsumi
  • Tomonobu Kodama
  • Hiroshi Aikawa
  • Masanari Onizuka
  • Minoru Iko
  • Kouhei Nii
  • Shuko Hamaguchi
  • Housei Etou
  • Kimiya Sakamoto
  • Ritsurou Inoue
  • Hiroya Nakau
  • Kiyoshi Kazekawa
Interventional Neuroradiology

Abstract

Introduction

We assessed the morphological change of calcified plaque after carotid artery stenting (CAS) in vessels with heavily calcified circumferential lesions and discuss the possible mechanisms of stent expansion in these lesions.

Methods

We performed 18 CAS procedures in 16 patients with severe carotid artery stenosis accompanied by plaque calcification involving more than 75% of the vessel circumference. All patients underwent multidetector-row computed tomography (MDCT) to evaluate lesion calcification before and within 3 months after intervention. The angiographic outcome immediately after CAS and follow-up angiographs obtained 6 months post-CAS were examined.

Results

The preoperative mean arc of the calcifications was 320.1 ± 24.5° (range 278–360°). In all lesions, CAS procedures were successfully carried out; excellent dilation with residual stenosis ≤30% was achieved in all lesions. Post-CAS MDCT demonstrated multiple fragmentations of the calcifications in 17 of 18 lesions (94.4%), but only cracks in the calcified plaque without fragmentation in one (5.6%). Angiographic study performed approximately 6 months post-CAS detected severe restenosis in one lesion (5.6%) without fragmentation of calcified plaque.

Conclusions

Excellent stent expansion may be achieved and maintained in heavily calcified circumferential carotid lesions by disruption and fragmentation of the calcified plaques.

Keywords

Atherosclerosis Calcification Carotid artery stenting Carotid plaque Carotid stenosis 

Notes

Acknowledgment

We would like to thank Ms. Ursula Petralia for assistance in preparing this article.

Conflict of interest statement

We declare that we have no conflict of interest.

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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Masanori Tsutsumi
    • 1
  • Tomonobu Kodama
    • 1
  • Hiroshi Aikawa
    • 1
  • Masanari Onizuka
    • 1
  • Minoru Iko
    • 1
  • Kouhei Nii
    • 1
  • Shuko Hamaguchi
    • 1
  • Housei Etou
    • 1
  • Kimiya Sakamoto
    • 1
  • Ritsurou Inoue
    • 1
  • Hiroya Nakau
    • 1
  • Kiyoshi Kazekawa
    • 1
    • 2
  1. 1.Department of Neurosurgery and NeuroradiologyFukuoka University Chikushi HospitalFukuokaJapan
  2. 2.Department of NeurosurgeryFukuoka University Chikushi HospitalFukuokaJapan

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