Endovascular treatment of an internal carotid artery thrombus using reversal of flow: A case report Juan C. Parodi, MD, Brian G. Rubin, MD, Ali Azizzadeh,

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Presentation transcript:

Endovascular treatment of an internal carotid artery thrombus using reversal of flow: A case report Juan C. Parodi, MD, Brian G. Rubin, MD, Ali Azizzadeh, MD, Michele Bartoli, MD, Gregorio A. Sicard, MD Journal of Vascular Surgery Volume 41, Issue 1, Pages 146-150 (January 2005) DOI: 10.1016/j.jvs.2004.10.033 Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

Fig 1 Preoperative duplex scan demonstrates the presence of homogenous echolucent material in the internal carotid artery consistent with a thrombus. Journal of Vascular Surgery 2005 41, 146-150DOI: (10.1016/j.jvs.2004.10.033) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

Fig 2 First angiogram shows nearly completely occlusive thrombus in the right internal carotid. Journal of Vascular Surgery 2005 41, 146-150DOI: (10.1016/j.jvs.2004.10.033) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

Fig 3 Second angiogram shows an evolution of the thrombus in the internal carotid, with a threatening tail. Journal of Vascular Surgery 2005 41, 146-150DOI: (10.1016/j.jvs.2004.10.033) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

Fig 4 The Parodi Anti-Embolism System (PAES, ArteriA Medical Science, San Francisco, Calif): (a) PAES sheath, placed in the common carotid artery below the bifurcation, (b) is armed with a soft occlusion balloon and a second occlusion balloon is placed into the external carotid artery. (c), The balloons in the common and external carotid arteries are inflated, which results in reversal of flow. Journal of Vascular Surgery 2005 41, 146-150DOI: (10.1016/j.jvs.2004.10.033) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

Fig 5 Angiogram after treatment with PAES shows no residual stenosis. Journal of Vascular Surgery 2005 41, 146-150DOI: (10.1016/j.jvs.2004.10.033) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

Fig 6 Postoperative carotid Doppler ultrasound scan demonstrates shows lack of stent apposition to vessel wall. Journal of Vascular Surgery 2005 41, 146-150DOI: (10.1016/j.jvs.2004.10.033) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions