tailieunhanh - báo cáo khoa học: "Successful interdisciplinary management of the misdeployment of two self-expanding stents into the internal carotid artery: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: successful interdisciplinary management of the misdeployment of two self-expanding stents into the internal carotid artery: a case report | Jost et al. Journal of Medical Case Reports 2010 4 397 http content 4 1 397 WV journalof medical l rCASE REPORTS CASE REPORT Open Access Successful interdisciplinary management of the misdeployment of two self-expanding stents into the internal carotid artery a case report 1 1 2 3 14 Dominik Jost Helfried Meissner Henning von Loewensprung Thomas Guethe Thomas Hupp 1 Hans Henkes5 6 Abstract Introduction With the widespread use of carotid artery stenting previously unknown technical mistakes of this treatment modality are now being encountered. There are multiple strategies for the treatment of in-stent restenosis. With regard to surgical management endarterectomy and patch plasty are favored. To the best of our knowledge this report is the first description of a complete stent removal by the eversion technique. Case presentation We report the case of a 63-year-old Caucasian man with misdeployment of two stents into his stenotic proximal internal carotid artery resulting in a high-grade mechanical obstruction of the internal carotid artery lumen. With the contralateral internal carotid artery already occluded and associated stenoses of both proximal and distal vertebral arteries an interdisciplinary therapeutic concept was applied. Bilateral balloon angioplasty and stenting of the proximal and distal stenotic vertebral arteries were carried out to provide sufficient posterior collateral blood flow followed by successful surgical stentectomy and carotid endarterectomy using the eversion technique. Duplex scanning and neurological assessments were normal over a 12-month follow-up period. Conclusions Interdisciplinary treatment is a recommended option to protect patients from further impairment. Further evaluation in larger studies is highly recommended. Introduction Stroke is the most common cause of disability. Prevention of stroke by carotid endarterectomy CEA or carotid artery stenting CAS is widely accepted and they are basically .

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