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REVIEW  CAROTID STENTING AND ENDARTERECTOMY 

The Journal of Cardiovascular Surgery 2017 February;58(1):25-34

DOI: 10.23736/S0021-9509.16.09813-X

Copyright © 2016 EDIZIONI MINERVA MEDICA

language: English

Recent developments of imaging modalities of carotid artery stenting

Tomoyuki UMEMOTO 1, Andrea PACCHIONI 2, Dimitrios NIKAS 3, Bernhard REIMERS 4

1 Department of Cardiovascular Medicine, Tokyo Medical and Detal University, Tokyo, Japan; 2 Department of Cardiology, Ospedale Civile Mirano, Mirano, Venice, Italy; 3 Department of Cardiology, Ioannina University Hospital, Ioannina Medical School, Ioannina, Greece; 4 Department of Cardiovascular Medicine, Humanitas Clinical and Research Institute, Rozzano, Milan, Italy


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Compared with conventional angiogram-guided procedure, intravascular imaging modalities give us a lot of useful information to make the procedure better. Intravascular imaging modalities give us the information about lesion characters, reference vessel diameter and the interaction between the stent strut and the plaque such as stent strut malapposition or plaque prolapse in real time during the procedure. We can change our strategy according to this information. Intravascular ultrasound (IVUS) is a most common intravascular imaging modality during carotid artery stenting (CAS) in these days. Its advantage is easy to use compared with optical coherence tomograpy (OCT) which has been reported recently in some case reports or case series. However, due to its high resolution, OCT provides more detailed information especially about plaque prolapse and strut malapposition. IVUS and OCT have a potential to improve acute result and reduce the procedural complication by providing the data of lesion character, reference vessel diameter and the interaction of stent strut and vessel wall. Interventionalists who perform CAS procedure should acquire proficiency in imaging modalities during CAS procedure.


KEY WORDS: Ultrasonography, interventional - Tomography, optical coherence - Endovascular procedures

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