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Anatomical Considerations for Endovascular Intervention for Extracranial Carotid Disease: A Review of the Literature and Recommended Guidelines. J Clin Med 2020 Oct 27;9(11)

Date

10/31/2020

Pubmed ID

33121192

Pubmed Central ID

PMC7693974

DOI

10.3390/jcm9113460

Scopus ID

2-s2.0-85104863917 (requires institutional sign-in at Scopus site)   7 Citations

Abstract

Patient selection for endovascular intervention in extracranial carotid disease is centered on vascular anatomy. We review anatomical considerations for non-traumatic disease and offer guidelines in patient selection and management. We conducted a systematic literature review without meta-analysis for studies involving anatomical considerations in extracranial carotid intervention for non-traumatic disease. Anatomical considerations discussed included aortic arch variants, degree of vessel stenosis, angulation, tortuosity, and anomalous origins, and atheromatous plaque morphology, composition, and location. Available literature suggests that anatomical risks of morbidity are largely secondary to increased procedural times and difficulties in intervention system delivery. We recommend the prioritization of endovascular techniques on an individual basis in cases where accessible systems and surgeon familiarity provide an acceptable likelihood of rapid access and device deployment.

Author List

Scullen T, Mathkour M, Carr C, Wang A, Amenta PS, Nerva JD, Dumont AS

Author

John D. Nerva MD Assistant Professor in the Neurosurgery department at Medical College of Wisconsin