Duplex ultrasound assisted endovascular revascularization of chronic internal carotid artery occlusion: technical
Nassir Rostambeigi1, Rakesh Khatri1, Ameer E Hassan1
1Zeenat Qureshi Stroke Research Center, University of Minnesota, Minneapolis, MN 55455 USA.
Insights
Duplex ultrasound guidance improves endovascular revascularization for carotid artery occlusion. This technique helps prevent vessel injury, potentially reducing stroke risk in high-risk patients.
Area of Science:
- Neurology
- Vascular Surgery
- Medical Imaging
Background:
- Carotid artery occlusion is a significant risk factor for ischemic stroke.
- Endovascular treatment is a therapeutic option for high-risk patients with carotid artery occlusion.
- Successful endovascular recanalization requires precise visualization of the vessel wall.
Purpose of the Study:
- To describe the procedural details of using duplex ultrasound guidance during endovascular revascularization for carotid artery occlusion.
- To highlight the value of ultrasound guidance in visualizing endovascular devices and the vessel wall.
Main Methods:
- A case report of a 54-year-old woman with symptomatic carotid occlusion.
- Endovascular revascularization was performed with duplex ultrasound assistance.
- Ultrasound was used for device visualization and vessel wall characterization.
Main Results:
- Successful endovascular revascularization was achieved with ultrasound guidance.
- The procedure involved traversing the occluded segment and accurate stent deployment.
- The patient remained free of ischemic symptoms at 3-month follow-up.
Conclusions:
- Duplex ultrasound guidance aids in preventing vessel wall injury and dissection during carotid artery revascularization.
- Ultrasound guidance may enhance outcomes for endovascular procedures in high-risk patients with carotid occlusion.
Abstract:
Carotid artery occlusion is a major risk factor for ischemic stroke. Endovascular treatment of carotid artery occlusion in high-risk patients offers a therapeutic option to reduce subsequent ischemic events. The technical success and avoidance of complications of the endovascular recanalization of occluded carotid artery is contingent on proper visualization of the vessel wall. To highlight the value of duplex ultrasound guidance, we herein described the procedural details of the use of ultrasound guidance for characterization and visualization of the endovascular devices as well as the vessel wall during endovascular revascularization. Patient was a 54-year-old woman, diagnosed with carotid occlusion with recurrent symptomatic episodes. Endovascular revascularization was successfully performed by ultrasound assistance upon traversing the occluded segment and accurate deployment of stent. The patient was followed for 3 months and has not experienced any ischemic symptoms. Duplex ultrasound guidance helps preventing the vessel wall injury and dissection during revascularization of chronically occluded carotid artery. Ultrasound guidance may improve the outcomes of the endovascular procedures in high-risk patients with carotid occlusion.
