0000000000281499
AUTHOR
Tadeusz Popiela
Revascularization technique for a long occlusive lesion in a case of symptomatic chronic occlusion of the internal carotid artery
Mid-term and late results of endovascular treatment for symptomatic carotid artery stenosis under proximal protection
Introduction: Although filters are still preferred during carotid stenting, proximal protection systems (PPS) are increasingly used during these procedures. PPS seem to be safer than distal systems, especially in symptomatic patients, but evidence supporting their use is limited. Aim: This was a post hoc survey with 30-day mid-term and long-term follow up, which was aimed at assessment of the safety and efficacy of stenting of the internal carotid artery under PPS in symptomatic patients. Material and methods: We analysed the results of stenting in 120 symptomatic patients presenting with at least 60% stenosis. Patients were aged 67.9 ±9.8 years, and 12 patients were older than 80 years. An…
Mechanical rotational thrombectomy with Rotarex system augmented with drug-eluting balloon angioplasty vs. stenting for the treatment of acute thrombotic and critical limb ischaemia in the femoropopliteal segment
Introduction Mechanical thrombectomy is an alternative to local thrombolysis for the treatment of severe ischaemia in the femoropopliteal segment, but stent implantation is usually required after this procedure. The use of drug-eluting balloons (DEBs) may overcome long-term problems associated with stents, but it remains unclear how often such a treatment is technically feasible and efficient. Aim This post hoc single-centre study was aimed at assessment of the feasibility, safety and efficacy of mechanical thrombectomy followed by application of DEBs. Material and methods Fifty-one patients, aged 69.1 ±11.6 years, were managed for acute thrombotic or chronic critical ischaemia in the femor…
The use of a proximal protection system, a reperfusion catheter, and new-generation mesh stents in combined endovascular therapy for a long, symptomatic dissection of the right internal carotid artery.
Mechanical thrombectomy for rescue treatment of severe thrombosis of the superior sagittal sinus with the use of Penumbra and AngioJet catheters
Early results of endovascular treatment of patients with bilateral stenoses of the internal carotid arteries using proximal protection systems at 30-day follow-up
Abstract Background Although surgical endarterectomy remains the treatment of choice for carotid artery stenosis, carotid artery stenting (CAS) with use of proximal protection systems (PPS) plays an very important role as alternative treatment modality, especially in patients with critical, symptomatic lesions. This study was single-centre study to evaluate the technical and clinical success of proximal protection devices as the first choice for embolic protection in symptomatic and asymptomatic carotid stenosis in patients with bilateral, advanced lesions of carotid arteries (bilateral stenoses or stenosis and occlusion). Methods This was a post hoc analysis, with 30-day follow up. We anal…
Endovascular management of carotid artery dissections with the use of new generation stents and protection systems
Dissection of the internal carotid artery (ICA) is a rare disease, but in young patients is responsible for about 20% of cerebral events. We presented three different cases of ICA dissection, including one iatrogenic and two spontaneous ones, which were successfully managed endovascularly, with the use of different techniques, different protection devices and stents. In this article, the clinical management and details of procedures were described.
Endovascular therapy of symptomatic high-grade stenosis of left internal carotid artery in C6 segment using Elutax “3” Neuro pDEB
Endovascular management of carotid and vertebral artery dissections with new generation double-mesh stent and protection systems – single-center early and midterm results
Introduction Symptomatic dissections (SD) of cervical arteries are still a therapeutic problem. Although endovascular management (EM) is currently a preferred method of treatment of SD, complications associated with this method of treatment in published reports are quite frequent (3-16%). Aim In this retrospective study we analyzed the results of EM with novel, double-mesh stent and protection systems (PS) for SD of the internal carotid (IC) or vertebral arteries (VA) that coexisted with hemodynamically significant stenosis or aneurysmatic dilatation of the dissected artery. Material and methods We evaluated the results of EM in 19 patients (men 15, median age: 55, range: 25-83), presenting…
Patient- and lesion-tailored algorithm of endovascular treatment for arterial occlusive disease of extracranial arteries supplying the brain: safety of the treatment at 30-day follow-up
Introduction: Although surgical endarterectomy remains the treatment of choice for carotid artery stenosis, stenting plays an important role as an alternative treatment modality, especially in high-risk patients. The actual safety profile associated with stenting procedures is probably better than that reported by randomized controlled trials. Aim : To assess the safety of stent implantations in extracranial arteries supplying the brain, and also to identify risk factors associated with this procedure. Material and methods: This was a post hoc analysis, with 30-day follow-up. We analyzed the results of treatment of 372 patients who underwent 408 procedures, 197 such procedures in asymptomat…
Treatment of high- and intermediate-risk pulmonary embolism using the AngioJet percutaneous mechanical thrombectomy system in patients with contraindications for thrombolytic treatment – a pilot study
Introduction Intravenous thrombolysis is the treatment of choice in patients presenting with high- and intermediate-risk pulmonary embolism. The role of percutaneous mechanical pulmonary thrombectomy (PMPT) is not fully established, although selected patients can be managed with this method. Aim This open-label single-centre prospective pilot study was aimed at assessing the feasibility of PMPT for the treatment of severe pulmonary embolism in a Polish hospital. We also evaluated the safety and efficacy of such management. Material and methods We managed 7 patients, aged 52.7 ±16.6 years, presenting with high- and intermediate-risk pulmonary embolism (4 patients with class 5 and one patient…
Endovascular thrombectomy with the AngioJet System for the treatment of intermediate-risk acute pulmonary embolism: a case report of two patients
Acute pulmonary embolism (PE) is one of the leading causes of death and ranks third, after myocardial infarction and cerebral stroke, among fatal hospital-related cardiovascular events [1–3]. Mortality associated with PE can be lowered by early treatments aimed at restoring patency of occluded pulmonary arteries (PAs). Although systemic thrombolysis remains the recommended management of PE [4], recent advances in endovascular techniques, especially of rheolytic thrombectomy, suggest that the endovascular approach can represent an alternative therapeutic strategy [5–9]. Here we describe endovascular treatment of two patients with acute PE. We used the AngioJet (Boston Scientific, Natick, MA,…
Endovascular mechanical thrombectomy of the inferior vena cava and iliac veins with the use of Aspirex®S device in a paediatric patient
Phlegmasia cerulea dolens, which is the most severe clinical presentation of deep venous thrombosis and results from an almost complete occlusion of the major and collateral venous outflow routes from the extremity, is very rarely seen in children. Here we describe the treatment of an 11-year-old boy with Down syndrome who presented with thrombotic occlusion of the inferior vena cava and both iliac veins. We present a step-by-step technique of endovascular mechanical thrombectomy of these veins with the use of the Aspirex®S thrombectomy device. Endovascular treatment was followed by local intravenous thrombolysis. Because of recurrent thrombosis, which occurred 4 days later, endovascular th…