Cerebrovascular & Carotid
Artery Disease
How Can I Get Screened & Treated for Cerebrovascular & Carotid Artery Disease?
How can I get screened?
"Currently The Toronto Endovascular Centre is the only Legs for Life
Site
In Canada performing Abdominal Aortic Screening at 131 Hazelton
Avenue, Ste 102 , Toronto .
Call the Toronto Endovascular Centre at 416-925-2676
Arrange to bring a requisition form for ultrasound from your family physician
at the time of your appointment at The Toronto Endovascular Centre"
To print requisition form, click
here
How can I get treated for PAD?
Call the Toronto Endovascular Centre at 416-925-2676, to make an
appointment with one of our Vascular Physicians. You will require a referral
letter from family doctor or specialist.
Carotid Stent Case
Dr. S. Kundu BSc, MD, FRCPC, DABR, FASA
Dr. J.M. You MD, FRCPS
Clinical History
64 years old male presented with a 6 month history
of intermittent difficulty with speech, and
transient numbness every three to four days
and transient numbness in right hand. Carotid
Ultrasound, echocardiogram, ECG and bloodwork
were all negative. Patient referred to speech
pathologist and a psychiatrist. After three
months patient referred to a Neurologist
and a Computed Tomography Angiogram was performed.
Clinical Investigation
Computed Tomography Angiogram demonstrated a severe eccentric
Left Common Carotid Stennosis (Fig 1 & 2). Patient was referred
for Carotid Stenting as surgery was determined to be a difficult
option given the proximal location of the stennosis.
Materials and Methods
A Thoracic Aortogram demonstrated the origin of the
great arch vessels to be within normal limits. There
was a moderate to severe narrowing of the proximal Left
Common Carotid Artery (Fig 3). A left cerebral angiogram
was within normal limits Cannulation past the stennosis
was performed with a .035 Cook Roas Runner Hydrophilic
Wire, 5 French Cook DAV 100 cm catheter, and a 5 French
Cook Shuttle Sheath. A 6 mm Angioguard Cordis Distal
Protection Device was inserted in the proximal left internal
carotid artery. A 7 x 40 mm Cordis Precise Stent was
inserted at the site of the stennosis (Fig 4). A post
stent placement balloon dilation was performed with a
Cordis 6 x 20 mm Ameia balloon. Post balloon dilation,
the left common carotid artery appeared widely patent
(Fig 5 & 6). A left cerebral angiogram was within
normal limits. Case performed at Scarborough General
Hospital: General Campus.
Clinical Outcome
There was a complete resolution of the patient's symptoms
with no further episodes of speech difficulty or numbness.
Summary
Carotid stenting is a viable treatment alternative to
carotid endarterectomy in patients with proximal common
carotid artery lesions, operative risk factors, post-operative
restennosis, and high internal carotid artery lesions.
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