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Carotid endarterectomy with simultaneous retrograde common carotid artery stenting: Technical Considerations
Author(s) -
Bazan Hernan A.,
Sheahan Malachi,
Dardik Alan
Publication year - 2008
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.21730
Subject(s) - medicine , carotid endarterectomy , carotid stenting , shunt (medical) , internal carotid artery , common carotid artery , endarterectomy , carotid arteries , surgery , radiology
Carotid endarterectomy with simultaneous retrograde common carotid artery stenting (CEA‐RCCAS) is performed with increasing frequency to treat tandem common and internal carotid artery stenoses. Technical details are not clearly delineated in the literature. Our procedure aims to maximize procedural ease and cerebral protection. Although the need for the endovascular component being performed first, followed by shunt placement, and the use of short wires and sheaths has been advocated, we describe the avoidance of shunt placement and the use of long sheaths to facilitate the procedure using local anesthesia and cervical blockade. Use of local anesthesia, avoidance of a shunt, and use of a long sheath may increase the procedural applicability and safety in some patients. CEA‐RCCAS permits safe simultaneous treatment of tandem common and internal carotid artery stenoses. The use of technical adjuncts described here will permit further expansion of the procedure to allow additional patients to be treated in this hybrid fashion. © 2008 Wiley‐Liss, Inc.