The Carotid and Supra-Aortic Trunks Diagnosis, Angioplasty and Stenting Previously published as Angioplasty and Stenting of the Carotid and Supra Aortic Trunks The Carotid and Supra-Aortic Trunks Diagnosis, Angioplasty and Stenting 2ND EDITION EDITED BY MICHEL HENRY MD Interventional Cardiologist Cabinet de Cardiologie Nancy France Chief Patron Apollo Clinic Global Research Institute for Carotid and Peripheral Vascular Diseases Hyderabad India EDWARD B. DIETHRICH MD Arizona Heart Institute & Hospital Phoenix, AZ USA ANTONIOS POLYDOROU MD Interventional Cardiologist Panteleimon General Hospital Athens Greece A John Wiley & Sons, Ltd., Publication This edition fi rst published 2011 © 2011 by Blackwell Publishing Ltd Blackwell Publishing was acquired by John Wiley & Sons in February 2007. Blackwell’s publishing program has been merged with Wiley’s global Scientifi c, Technical and Medical business to form Wiley-Blackwell. 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The fact that an organization or Website is referred to in this work as a citation and/or a potential source of further information does not mean that the author or the publisher endorses the information the organization or Website may provide or recommendations it may make. Further, readers should be aware that Internet Websites listed in this work may have changed or disappeared between when this work was written and when it is read. No warranty may be created or extended by any promotional statements for this work. Neither the publisher nor the author shall be liable for any damages arising herefrom. Library of Congress Cataloging-in-Publication Data The carotid and supra-aortic trunks : diagnosis, angioplasty and stenting / edited by Michel Henry and Edward B. Diethrich and Antonios Polydorou. – 2nd ed. p. ; cm. Includes bibliographical references and index. ISBN 978-1-4051-9854-7 (hardcover : alk. paper) 1. Carotid artery–Stenosis– Surgery. 2. Angioplasty. 3. Stents (Surgery) I. Henry, Michel, MD. II. Diethrich, Edward B., 1935– III. Polydorou, Antonios. [DNLM: 1. Carotid Stenosis–surgery. 2. Angioplasty. 3. Carotid Stenosis–diagnosis. 4. Stents. WL 355] RD598.6.C365 2011 617.4′13–dc22 2010036363 A catalogue record for this book is available from the British Library. This book is published in the following electronic formats: ePDF 9781444329810; Wiley Online Library 9781444329803; ePub 9781444329827 Set in 9.25/12 pt Minion by Toppan Best-set Premedia Limited 1 2011 Contents List of Contributors, viii Part 2 Clinical Assessment Preface, xii 10 Neurologic and neuropsychologic evaluation before and Acknowledgements, xiii after carotid angioplasty and stenting, 89 Hany Zakieldine 11 Cardiac assessment in carotid artery disease, 101 Ad. Polydorou, P. Megaloikonomos, V. Polydorou, Isabelle Part 1 Epidemiology, Anatomy and Imaging Henry, Michel Henry, Antonios Polydorou, T. Skandalakis 1 Epidemiology and pathophysiology of carotid artery Part 3 Carotid Artery Stenosis: Medical disease, 3 Treatment Kosmas I. Paraskevas, Nikolaos Bessias, Dimitri P. Mikhailidis 12 Carotid stenosis: primary prevention and medical 2 Neuroanatomy, 8 treatment, 111 Michael H. Wholey, Fadi El-Merhi George Ioan Pandele, Corina Dima-Cozma 13 Periprocedural management for carotid intervention, 118 3 Value of computed tomography and magnetic resonance Antonios Polydorou, P. Megaloikonomos, Ad. Polydorou, imaging, 15 V. Polydorou, Isabelle Henry, Michel Henry, T. Skandalakis Allan W. Reid, Giles H. Roditi 4 Diagnosis of carotid stenosis by duplex ultrasound, 28 Part 4 Carotid Artery Stenosis: Surgical Serge Kownator Treatments 5 Transcranial Doppler, 32 14 Carotid surgery: updates, techniques, and results, 127 Corinne Gautier Donald B. Reid, John G. Pollock, Edward B. Diethrich 6 Carotid plaque characterization using ultrasound, 44 15 Is carotid surgery still the gold standard in carotid Andrew N. Nicolaides, Maura Griffi n, Stavros K. intervention?, 136 Kakkos, George Geroulakos, Efthyvoulos Kyriacou, Edward B. Diethrich, Donald B. Reid Niki Georgiou 16 Referral for carotid endarterectomy and not carotid artery 7 Methods for evaluation of carotid stenosis, 62 stenosis: high risk revisited, 141 Isabelle Henry, Michel Henry Frank J. Criado 8 Role of intravascular ultrasound in carotid angioplasty and Part 5 Indications for Carotid Angioplasty stenting, 67 and Stenting Donald B. Reid, Khalid Irshad, Barun Majumdar, Edward B. Diethrich 17 Indications and contraindications for carotid artery stenting 9 Cerebral perfusion imaging, 76 in symptomatic patients, 147 Wei-Jian Jiang Edward B. Diethrich, Donald B. Reid v Contents 18 Indications and contraindications for carotid artery 32 Carotid artery stent restenosis, 290 stenting in asymptomatic patients: the case for risk Zvonimir Krajcer, Enrique Hernandez stratifi cation, 152 33 In-stent restenosis after carotid artery stenting: incidence Issam D. Moussa and management, 300 19 Various society guidelines for carotid artery stenting, 159 Dimitrios N. Nikas, Luca Favero, Salvatore Saccà, Zehra Jaffery, Rajan A.G. Patel, Tyrone J. Collins Giampaolo Pasqueto, Bernhard Reimers 20 Management of concomitant coronary and carotid disease, 164 Part 7 Carotid Angioplasty and Stenting: Mullasari Ajit, Balashankar Gomathi Clinical Results 34 Does the learning curve infl uence the outcome of carotid artery stenting?, 309 Part 6 Carotid Angioplasty and Stenting: Jonathan Smout, Gerard Stansby, Sumaira Macdonald Techniques 35 Critical review of randomized studies and registries, 315 Zehra Jaffery, Arthur “Chip” Grant, Tyrone J. Collins 21 Equipment needed for carotid angioplasty and stenting: tips and tricks, 171 36 How to interpret critical reviews of randomized studies and Hugo F. Londero, Leandro Martinez Riera, registries, 326 Francisco E. Paoletti Eric A. Heller, William A. Gray 22 Evolution in carotid stenting with cerebral protection, 185 37 The Carotid Revascularization Endarterectomy versus Jacques Théron Stenting Trial (CREST): implications for clinical practice, 335 23 Embolic protection devices: choice, 191 Edward B. Diethrich, Mouhamadou N’Diaye, Donald B. Reid Michel Henry, Isabelle Henry, Antonios Polydorou, Michèle Hugel 38 Carotid angioplasty under cerebral protection with the PercuSurge Guardwire™ device, 339 24 Carotid angioplasty under protection: limitations, dark side, Michel Henry, Antonios Polydorou, Isabelle Henry, how to avoid complications, 208 Michèle Hugel Michel Henry, Isabelle Henry, Amira Benjelloun, Antonios Polydorou, Michèle Hugel 39 Carotid angioplasty and stenting under protection: results with different fi lters, 350 25 Basic techniques of carotid artery stenting, 230 Jennifer Franke, Horst Sievert Zvonimir Krajcer, Enrique Hernandez 40 Carotid angioplasty and stenting under protection: results 26 Managing carotid anatomic adversity, 247 with the Mo.Ma™ device, 355 Subbarao Myla, Sepideh Kazemi Alberto Cremonesi, Shane Gieowarsingh, Fausto Castriota 27 Choice of the stent: does the type of stent infl uence 41 Cerebral protection using fl ow reversal, 361 the outcome of carotid artery angioplasty and Claudio Schönholz, Renan Ufl acker, Marcelo Guimaraes, stenting?, 255 Juan C. Parodi Alberto Cremonesi, Shane Gieowarsingh, Fausto Castriota 42 New distal embolic protection device: FiberNet® three- 28 Carotid angioplasty and stenting: indications for covered dimensional fi lter, 367 stents, 262 Michel Henry, Antonios Polydorou, Isabelle Henry, Emilio Calabrese, Luigi Inglese Ad. Polydorou, V. Polydorou, Michèle Hugel 29 Complication avoidance and management in cervical 43 Patient follow-up after carotid angiography and carotid revascularization, 267 stenting, 379 Lee R. Guterman Antonios Polydorou, P. Megaloikonomos, Ad. Polydorou, 30 Endovascular recanalization of chronic carotid artery V. Polydorou, Isabelle Henry, Michel Henry, T. Skandalakis occlusion, 277 Hsien-Li Kao Part 8 Intracranial Endovascular Therapy 31 Interventional treatment of carotid artery dissection: role of endovascular technology, 285 44 How to develop a stroke program, 387 Michel E. Mawad James T. DeVries, Christopher J. White vi Contents 45 Elective endovascular revascularization of the intracranial 50 Percutaneous transluminal angioplasty and stenting of cerebral arteries, 392 extracranial vertebral artery stenosis, 458 Dorothea Strozyk, H. Christian Schumacher, Michel Henry, Antonios Polydorou, Isabelle Henry, Philip M. Meyers, Randall T. Higashida Ad. Polydorou, Michèle Hugel 46 Endovascular therapy for acute stroke, 412 51 Infl ammatory arteritis in supra-aortic vessels: endovascular Lee R. Guterman, Eve A. Guterman treatment, 473 Sriram Rajagopal, Lakshmi Gopalakrishnan 47 Intracranial aneurysm: current and future minimally invasive endovascular treatment methods, 420 52 Extracranial carotid aneurysms: interventional Isabel Wanke, Zsolt Kulcsar, Stephan G. Wetzel, treatment, 478 Daniel A. Rüfenacht Emilio Calabrese 48 Intracranial vertebral artery stenting, 427 53 Balloon angioplasty and stent placement in the common Jonathan A. Rapp, Anil Verma, Tyrone J. Collins carotid artery, 484 Jennifer Franke, Horst Sievert Part 9 Other Supra-Aortic Occlusive Arterial Part 10 Future of Carotid Stenting Diseases: Endovascular Treatment 54 Future of carotid stenting, 491 49 Percutaneous transluminal angioplasty of the subclavian Michael H. Wholey arteries, 439 Michel Henry, Isabelle Henry, Antonios Polydorou, Michèle Hugel Index, 496 vii List of contributors Mullasari Ajit MD DM DNB Alberto Cremonesi MD Jennifer Franke MD Director – Cardiology GVM Care and Research CardioVascular Center Frankfurt Institute of Cardio - Vascular Diseases Interventional Cardio - Angiology Unit Frankfurt The Madras Medical Mission Villa Maria Cecilia Hospital Germany M ogappair Cotignola Chennai Italy Corinne Gautier MD India Department of Cardiology Frank J. Criado MD FACS FSVM U niversity of Lille Amira Benjelloun MD V ascular Surgery and Endovascular Intervention Lille Professor of Vascular Surgery Union Memorial Hospital - MedStar Health France Clinique Coeur et Vaisseaux B altimore, MD R abat Sale USA George Geroulakos MD ECFMG FRCS Morocco PhD James T. DeVries MD Clinical Senior Lecturer in Vascular Surgery Nikolaos Bessias MD D ivision of Cardiology Charing Cross Hospital Department of Vascular Surgery Dartmouth - Hitchcock Medical Center Imperial College Red Cross Hospital Lebanon London Athens UK G reece Edward B. Diethrich MD Arizona Heart Institute & Hospital Niki Georgiou RN Emilio Calabrese MD Phoenix, AZ Vascular Screening and Diagnostic Centre Cardiovascular Surgeon and Interventional USA Nicosia Radiologist Cyprus National Center for Limb Salvage Corina Dima- Cozma MD PhD Monza Policlinic Lecturer in Internal Medicine Shane Gieowarsingh MB MRCP Milan D epartment of Internal Medicine University Hospitals of Leicester Italy C ardiovascular Rehabilitation Clinic Leicester and Rehabilitation Hospital UK Geneva Foundation for Medical Education and “ Gr. T. Popa ” University of Medicine and Pharmacy Research Ia s¸ i Geneva Balashankar Gomathi MD DNB DM Romania Switzerland Consultant Cardiologist Department of Cardiology Fausto Castriota MD Fadi El - Merhi MD Institute of Cardio - Vascular Diseases Department of Diagnostic Radiology The Madras Medical Mission GVM Care and Research American University of Beirut Medical Center M ogappair Interventional Cardio - Angiology Unit Beirut Chennai Villa Maria Cecilia Hospital Lebanon India Cotignola Italy Luca Favero MD Lakshmi Gopalakrishnan MD DNB Tyrone J. Collins MD Cardiology Department Southern Railway Hospital Mirano Public Hospital I nstitute for Cardiac Treatment and Research Department of Cardiology Mirano Perambur Ochsner Medical Center Italy Chennai New Orleans, LA India USA viii List of contributors Arthur “ Chip ” Grant MD Michel Henry MD Wei-Jian Jiang MD Department of Cardiology Interventional Cardiologist Department of Neurology and Interventional Ochsner Medical Center Cabinet de Cardiologie Neuroradiology New Orleans, LA Nancy B eijing Tiantan Hospital USA France The Capital University of Medical Sciences and Beijing William A. Gray MD Chief Patron China A pollo Clinic Director of Endovascular Services Center for Interventional Vascular Therapy G lobal Research Institute for Carotid and Stavros K. Kakkos MD MSc PhD DIC RVT Peripheral Vascular Diseases New York-Presbyterian Hospital/Columbia Assistant Professor Hyderabad University Medical Center Department of Vascular Surgery India Associate Professor of Clinical Medicine Columbia University of Patras Medical School University College of Physicians and Surgeons Patras New York, NY Enrique Hernandez MD G reece USA Department of Interventional Cardiology Lenox Hill Hospital Hsien - Li Kao MD Maura Griffi n DMU MSc PhD New York, NY Associate Professor of Cardiology Director of Interventional Cardiology Vascular Noninvasive Diagnostic Centre National Taiwan University Medical School Hospital Episcopal San Lucas London D irector of Cardiac Cath Lab Ponce, PR UK N ational Taiwan University Hospital Puerto Rico Taipei USA Marcelo Guimaraes MD Taiwan Interventional Radiology Medical University of South Carolina Randall T. Higashida MD FAHA Sepideh Kazemi MD Clinical Professor of Radiology, Charleston, SC Interventional Cardiologist Neurological Surgery, Neurology, & Anesthesiology USA Hoag Memorial Hospital Presbyterian Chief, Division of Neuro Interventional Radiology Newport Beach, CA Departments of Radiology, Neurology, Eve A. Guterman USA Neurosurgical Surgery, and Anesthesiology Student University of California at San Francisco Barnard College San Francisco, CA Serge Kownator MD FACC FESC Columbia University USA Cardiovascular Center New York, NY Thionville USA France Mich è le Hugel MD Cabinet de Cardiologie Lee R. Guterman PhD MD Nancy Zvonimir Krajcer MD Medical Director of Stroke Services France P eripheral Vascular Fellowship Program Director Catholic Health System and Buffalo Neurosurgery and Department of Cardiology Group A pollo Clinic St. Luke ’ s Episcopal Hospital Buffalo, NY G lobal Research Institute for Carotid and Texas Heart Institute USA Peripheral Vascular Diseases Professor of Medicine at Baylor College of Hyderabad Medicine Eric A. Heller MD India University of Texas Houston, TX Postdoctoral Clinical Fellow USA D ivision of Cardiology Luigi Inglese MD New York-Presbyterian Hospital/Columbia Interventional Cardiology University Medical Center San Donato Policlinic Zsolt Kulcsar MD New York, NY Milan Neuroradiology USA Italy Clinic Hirslanden Zurich Isabelle Henry MD Khalid Irshad FRCS Switzerland Interventional Cardiologist Vascular & Endovascular Institute Polyclinique Bois - Bernard Wishaw Efthyvoulos Kyriacou PhD Bois - Bernard UK Associate Professor France C omputer Science and Engineering Department Frederick University Zehra Jaffery MD Nicosia Department of Cardiology Cyprus Ochsner Medical Center New Orleans, LA USA ix List of contributors Hugo F. Londero MD FSCAI Issam D. Moussa MD Giampaolo Pasqueto MD Servicio de Hemodinamia e Intervenciones por Director, Endovascular Service Cardiology Department Cateterismo D ivision of Cardiology Mirano Public Hospital Sanatorio Allende NYPH/Weill Cornell Medical Center Mirano C ordoba Associate Professor of Medicine Italy A rgentina W eill Medical College of Cornell University New York, NY Rajan A.G. Patel MD Sumaira Macdonald FRCP FRCR PhD USA Department of Cardiology Interventional Radiology Ochsner Medical Center Freeman Hospital Subbarao Myla MD FACC FSCAI New Orleans, LA Newcastle upon Tyne Medical Director USA UK C ardiovascular Laboratories & CV Research H oag Memorial Hospital Presbyterian John G. Pollock FRCS Barun Majumdar FRCS Newport Beach, CA G lasgow Royal Infi rmary USA Vascular & Endovascular Institute Glasgow Wishaw UK UK Mouhamadou N’ D iaye MD Fann Hospital Ad. Polydorou MD Leandro Martinez Riera MD Dakar Cardiology Department Senegal Servicio de Hemodinamia e Intervenciones por Air Force Hospital Cateterismo Athens Sanatorio Allende Andrew N. Nicolaides MS FRCS FRCSE G reece C ordoba PhD (Hon) A rgentina Emeritus Professor of Vascular Surgery Antonios Polydorou MD I mperial College London Interventional Cardiologist Michel E. Mawad MD London Panteleimon General Hospital Professor of Radiology UK Athens Baylor College of Medicine G reece Houston, TX Dimitrios N. Nikas MD PhD USA Cardiology Department V. Polydorou MD Mirano Public Hospital 2nd Internal Medicine Department P. Megaloikonomos MD Mirano Air Force Hospital Cardiology Department Italy Athens General Hospital of Athens “ Evangelismos ” G reece Athens George Ioan Pandele MD PhD G reece P rofessor in Internal Medicine Sriram Rajagopal MD DM D epartment of Internal Medicine Southern Railway Hospital Philip M. Meyers MD “ G r. T. Popa” University of Medicine and Pharmacy I nstitute for Cardiac Treatment and Research Departments of Radiology and Neurological Ia s¸ i Perambur Surgery Romania Chennai Columbia University India College of Physicians and Surgeons Francisco E. Paoletti MD New York, NY Servicio de Hemodinamia e Intervenciones por Jonathan A. Rapp MD USA Cateterismo Department of Cardiovascular Diseases Sanatorio Allende Ochsner Medical Center Dimitri P. Mikhailidis MD FFPM C ordoba New Orleans, LA FRCPath FRCP A rgentina USA Academic Head Department of Clinical Biochemistry (Vascular Kosmas I. Paraskevas MD FASA Allan W. Reid FRCR FRCP Disease Prevention Clinics) Department of Vascular Surgery Department of Radiology Royal Free Hospital Campus Red Cross Hospital G lasgow Royal Infi rmary University College London Athens Glasgow London G reece UK UK Juan C. Parodi MD Donald B. Reid MD FRCS Vascular Surgery Vascular & Endovascular Institute Trinidad Hospital Wishaw Buenos Aires UK A rgentina x