Carotid Stenting How to properly select suitable Patients · Practical Recommendation ICA Stenosis...
Transcript of Carotid Stenting How to properly select suitable Patients · Practical Recommendation ICA Stenosis...
Carotid Stenting – How to properly select suitable Patients
Stephan Duda
Carotid Stenting – How to notselect unsuitable Patients
Stephan Duda
Disclosure
Speaker name: S. Duda
.................................................................................
I have the following potential conflicts of interest to report:
Consulting
Employment in industry
Stockholder of a healthcare company
Owner of a healthcare company
Other(s)
I do not have any potential conflict of interestX
ESC-Guidelines
CAS: Impact of Technical and Anatomical Factors
Naggara et al.: Stroke 42: 380-8 (2011)
• Difficult aortic arch
• Kinked ICA
• Thrombus
• Extreme calcification
Possible Contraindications
Arch Morphology
Arch Morphology
Hostile Aortic Arch
8F Cordis Simmonds (sidewinder) II
configurated introducer guide (Cordis)
Relative Contraindications against CAS
Aneurysm of
CCA
Acute Offspring of
LCCA
Coarctation
Aneurysm
of ICA
Relative Contraindications against CAS
Kinking
90° Angle
No more Contraindication to CAS„Near Occlusion with Collapse“
Pat. No more Contraindication to CAS
„Near Occlusion w/o Collapse“
• Extreme arch atherothrombosis
• Unpassable aortic arch
• Kinked ICA near lesion
• Extreme calcification
Absolute Contraindications
Pat.
Practical Recommendation
ICA Stenosis
Duplex Ultrasound
MRA/CTA
CEA CAS
Thank you
Carotid Stenting – How to properly select suitable Patients
Stephan Duda