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Autor: Jacqueline Saw
Herausgeber: Jacqueline Saw
Titel: Carotid Artery Stenting: The Basics
Verlag: Humana Press
ISBN/ISSN: 9781603273145
Auflage: 1
Preis : CHF 209.40
Erscheinungsdatum:
Inhalt
Kategorie: Medizin & Pharmazie
Sprache: English
Technische Daten
Seiten: 264
Kopierschutz: DRM
Geräte: PC/MAC/eReader/Tablet
Formate: PDF
Inhaltsangabe

Over the past three decades, carotid artery stenting has evolved to become a promising and viable alternative to carotid endarterectomy, especially for patients deemed to have high surgical risks. In Carotid Artery Stenting: The Basics, Jacqueline Saw and a panel of international experts on carotid artery stenting discuss in depth the details of all contemporary aspects of carotid stenting, while reviewing supporting studies, guidelines, technical perspectives, and peri-procedural management. This textbook serves as a learning resource on the multifaceted management of patients with carotid artery stenosis, with the key focus on extracranial carotid artery stenting. Additional sections detail the specifics of setting up and maintaining a laboratory and discuss the preparation of the carotid artery stenting procedure from both the patient and operator's perspective. Authoritative and highly practical, Carotid Artery Stenting: The Basics is an accessible guide and valuable resource for today's cardiologists, radiologists, and vascular surgeons.

Inhaltsverzeichnis
PREFACE7
CONTENTS8
CONTRIBUTORS10
I CAROTID ARTERY STENOSIS AND MANAGEMENT12
Carotid Artery Stenosis Prevalence and Medical Therapy13
Prevalence of Carotid Artery Stenosis (Extracranial and Intracranial)13
Incidence and Economic Burden13
Etiology14
Prevalence of Concomitant Coronary Artery Disease15
Risk of Stroke with Coronary Artery Bypass Surgery15
Correlation of Carotid Stenosis to Strokes15
Significance of a Carotid Bruit16
Typical Stroke Syndromes Associated with Extracranial Carotid Stenosis17
Evidence-Based Medical Therapy for Patients with Carotid Stenosis17
Primary Prevention of Traditional Cardiovascular Risk Factors19
Antiplatelet Therapies19
Aspirin19
Aspirin and Acute Stroke21
Dipyridamole21
Clopidogrel21
Summary of Antiplatelet Agents22
Statins23
Secondary Stroke Prevention24
ACE Inhibitors26
Secondary Stroke Prevention26
Anticoagulants26
Conclusions27
References27
Carotid Revascularization: Carotid Endarterectomy30
Introduction30
Preoperative Assessment31
Indications for CEA32
Symptomatic Carotid Artery Stenosis32
Asymptomatic Carotid Stenosis Trials33
Summary of the Indications 34
Surgical Technique35
Shunting or Not37
CEA Under Local Anesthesia vs. General Anesthesia37
Patch vs. Primary Closure38
Type of Patch38
A Variant Approach: Eversion Endarterectomy38
Complications39
Early Complications39
Stroke or death39
Hyperperfusion/cerebral hemorrhage39
Cranial nerve injuries40
Hemorrhage and infection40
Systemic complications40
Late Complications40
Recurrent stenosis40
False aneurysm41
Conclusions41
References41
Carotid Stenting Registries and Randomized Trials46
Introduction and Historical Background46
Early Multi-Center Cas Registries48
Pro-CAS49
ELOCAS49
The Global Carotid Artery Stent Registry49
Contemporary High Surgical Risk Cas Registries50
ARCHeR50
BEACH52
CABERNET52
CREATE53
MAVErIC53
MO.MA53
PASCAL54
PRIAMUS54
SECURITY54
Trials of cas vs. Cea54
The Stopped Trial55
CAVATAS55
The Wallstent Trial55
Community (Kentucky) Trial56
CARESS56
SAPPHIRE57
EVA-3S59
SPACE61
Meta-analyses of CAS vs. CEA Trial Data63
Post-Market Surveillance (Pms) Registries64
CAPTURE65
CASES-PMS65
EXACT66
Ongoing trials of cas vs. Cea66
CREST66
ICSS/CAVATAS-267
Act-168
ACST-268
TACIT68
Conclusion68
References69
II LABORATORY SETUP AND BACKGROUND NONINVASIVE IMAGING73
Catheterization Laboratory: X-Ray Equipment, Imaging Modalities and Programs, and Radiation Safety74
Introduction75
Imaging Equipment75
Intravascular Contrast Agents76
Imaging Modalities and Programs77
Radiation Safety81
Conclusions82
References82
Noninvasive Imaging of the Extracranial Carotid Circulation83
Introduction83
CT Angiography83
CT Technique84
Influence of Scan Speed84
Contrast Injection Protocols84
Image Reconstruction84
Image Interpretation88
CT Artifacts88
Validation Studies of CT Angiography88
MR Angiography88
Time-of-Flight MRA89
Contrast-Enhanced MRA92
Gadolinium92
MRA Validation93
Carotid UltraSonography93
Other Applications for Carotid Sonography97
Carotid Near and Total Occlusion98
Recommendations Regarding Imaging98
References98
III PATIENT AND OPERATOR PREPARATION FOR CAROTID STENTING101
Pre-procedural Patient Preparation102
Introduction102
Baseline Neurological Examination103
NIH Stroke Scale103
Adjusting Medications Prior to the Procedure107
Medication Adjustment Prior to Contrast Agents Use107
Medication Adjustment Prior to Carotid Intervention107
Use of Antiplatelet Agents