Carotid Stenting How to properly select suitable Patients · Practical Recommendation ICA Stenosis...

Carotid Stenting – How to properly select suitable Patients

Stephan Duda

Carotid Stenting – How to notselect unsuitable Patients

Stephan Duda

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

ESC-Guidelines

CAS: Impact of Technical and Anatomical Factors

Naggara et al.: Stroke 42: 380-8 (2011)

• Difficult aortic arch

• Kinked ICA

• Thrombus

• Extreme calcification

Possible Contraindications

Arch Morphology

Arch Morphology

Hostile Aortic Arch

8F Cordis Simmonds (sidewinder) II

configurated introducer guide (Cordis)

Relative Contraindications against CAS

Aneurysm of

CCA

Acute Offspring of

LCCA

Coarctation

Aneurysm

of ICA

Relative Contraindications against CAS

Kinking

90° Angle

No more Contraindication to CAS„Near Occlusion with Collapse“

Pat. No more Contraindication to CAS

„Near Occlusion w/o Collapse“

• Extreme arch atherothrombosis

• Unpassable aortic arch

• Kinked ICA near lesion

• Extreme calcification

Absolute Contraindications

Pat.

Practical Recommendation

ICA Stenosis

Duplex Ultrasound

MRA/CTA

CEA CAS

Thank you

Carotid Stenting – How to properly select suitable Patients

Stephan Duda