The strategy for internal carotid stenosis with thrombus

Area of Science:

• Vascular Surgery
• Neurology
• Interventional Cardiology

Background:

• Internal carotid artery (ICA) stenosis with thrombus poses a significant risk for cerebrovascular events.
• Traditional treatment options may carry risks of embolic complications.
• Novel endovascular techniques are being explored for managing complex carotid artery disease.

Purpose of the Study:

• To evaluate the safety and efficacy of percutaneous transluminal angioplasty (PTA) and stenting with a protective system in patients with ICA stenosis and thrombus.
• To compare outcomes of endovascular treatment versus surgical intervention in this specific patient cohort.

Main Methods:

• Retrospective analysis of 3 cases with ICA stenosis and thrombus.
• All patients received initial anticoagulation and antiplatelet therapy.
• Treatment strategies included carotid endarterectomy (CEA) in one case and PTA with stenting using a protective technique in two cases.

Main Results:

• Carotid endarterectomy (CEA) in one patient resulted in minor cerebral embolic infarction during the waiting period.
• Percutaneous transluminal angioplasty (PTA) and stenting with a protective system in two patients showed no embolic complications.
• Postoperative angiography confirmed adequate lumen dilatation after PTA/stenting.

Conclusions:

• Percutaneous transluminal angioplasty (PTA) and stenting using a protective system appears to be a safe and effective alternative for treating internal carotid artery (ICA) stenosis with thrombus.
• This endovascular approach may reduce the risk of embolic complications compared to delayed surgical intervention in select cases.