carotid stenting how to properly select suitable patients · practical recommendation ica stenosis...
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Carotid Stenting – How to properly select suitable Patients
Stephan Duda
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Carotid Stenting – How to notselect unsuitable Patients
Stephan Duda
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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
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ESC-Guidelines
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CAS: Impact of Technical and Anatomical Factors
Naggara et al.: Stroke 42: 380-8 (2011)
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• Difficult aortic arch
• Kinked ICA
• Thrombus
• Extreme calcification
Possible Contraindications
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Arch Morphology
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Arch Morphology
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Hostile Aortic Arch
8F Cordis Simmonds (sidewinder) II
configurated introducer guide (Cordis)
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Relative Contraindications against CAS
Aneurysm of
CCA
Acute Offspring of
LCCA
Coarctation
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Aneurysm
of ICA
Relative Contraindications against CAS
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Kinking
90° Angle
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No more Contraindication to CAS„Near Occlusion with Collapse“
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Pat. No more Contraindication to CAS
„Near Occlusion w/o Collapse“
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• Extreme arch atherothrombosis
• Unpassable aortic arch
• Kinked ICA near lesion
• Extreme calcification
Absolute Contraindications
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Pat.
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Practical Recommendation
ICA Stenosis
Duplex Ultrasound
MRA/CTA
CEA CAS
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Thank you
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Carotid Stenting – How to properly select suitable Patients
Stephan Duda