Stenting of Extracranial Carotid Artery Stenosis

Abstract

The purpose of this study is to evaluate our cases of cervical internal carotid artery stenosis for safty stenting. We investigate the preoperative internal carotid artery stenosis using by integrated backscatter (IBS) method of ultra sonography, comparing with the thirty five surgical specimens as to their nature, histological structure, thickness of fibrous cap. We choose the protection method according to plaque structure, and placed Easy-Wall stent or Smart stent after prePTA. We added post PTA according to the extent of expansion and IVUS findings. Calibrated IBS = IBS value (ROI)/intinal IBS value of ‘bleeding’, ‘lipid’, ‘thrombus’, ‘fiber’, ‘hyalinization’ were −27.5, −22.5, −15.2, −11.1, +2.1. That of the thin fibrous cap were −10.9*, that of thic fibrous cap were −2.4 (*p < 0.001). There was a good coleration between the extent of expansion and expected histological findings. All conplications were two cases of small cerebral infarction and a case of bleeding from the complicated lung cancer. The protection at prePTA lead to no comploications in case of acute cerebral infarctions. It is very important to check the histological specimen carefully for safty stenting.