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Tandem cervical carotid stenting for stenosis with flow diversion embolisation for the treatment of intracranial aneurysms

Jessica K Campos, Li-Mei Lin, Narlin B Beaty, Matthew T Bender, Bowen Jiang, David A Zarrin, Alexander L Coon
DOI: 10.1136/svn-2018-000187 Published 17 December 2018
Jessica K Campos
1Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Li-Mei Lin
2Department of Neurosurgery, University of California, Irvine, Orange, California, USA
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Narlin B Beaty
1Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Matthew T Bender
1Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Bowen Jiang
1Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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David A Zarrin
1Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Alexander L Coon
1Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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    Figure 1

    Carotid artery stent revascularisation treatment for cervical carotid stenosis. (A) Digital subtraction angiogram (lateral view) of right common carotid artery demonstrating stenosis distal to bifurcation (arrowhead). (B) Native fluoroscopy, lateral view, illustrating placement of self-expanding carotid stent across the length of stenotic lesion. Lateral view (C) control angiography and (D) native fluoroscopy immediately following stent placement confirms optimal luminal re-establishment. Follow-up at (E) 6 months and (F) 12 months demonstrates favourable luminal expansion after cervical carotid revascularisation.

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    Figure 2

    Pipeline embolisation device (PED) treatment of two right-sided intracranial carotid artery (ICA) aneurysms, 4 mm anterior choroidal aneurysm and a 5 mm communicating segment aneurysm, with occlusion demonstrated at 12 months. (A) Pre-embolisation 3D-rotational reconstructed image, oblique view, and (B) digital subtraction angiogram (lateral view) of right ICA demonstrating the right anterior choroidal aneurysm (red arrow) and communicating segment aneurysm (red arrowhead). Native fluoroscopy (C, anteroposterior (AP) view; D, lateral view) immediately following deployment confirms the single 3.75 mm by 16 mm PED (black arrow) was implanted across the length of both aneurysms with appropriate wall apposition (red arrow, communicating segment aneurysm). At 12 months, (E, lateral view) follow-up digital subtraction  angiogram of the right ICA confirms occlusion of both aneurysms and (F, AP view) patent distal vasculature.

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Stroke and Vascular Neurology: 10 (1)
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Tandem cervical carotid stenting for stenosis with flow diversion embolisation for the treatment of intracranial aneurysms
Jessica K Campos, Li-Mei Lin, Narlin B Beaty, Matthew T Bender, Bowen Jiang, David A Zarrin, Alexander L Coon
Stroke and Vascular Neurology Dec 2018, svn-2018-000187; DOI: 10.1136/svn-2018-000187

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Tandem cervical carotid stenting for stenosis with flow diversion embolisation for the treatment of intracranial aneurysms
Jessica K Campos, Li-Mei Lin, Narlin B Beaty, Matthew T Bender, Bowen Jiang, David A Zarrin, Alexander L Coon
Stroke and Vascular Neurology Dec 2018, svn-2018-000187; DOI: 10.1136/svn-2018-000187
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Tandem cervical carotid stenting for stenosis with flow diversion embolisation for the treatment of intracranial aneurysms
Jessica K Campos, Li-Mei Lin, Narlin B Beaty, Matthew T Bender, Bowen Jiang, David A Zarrin, Alexander L Coon
Stroke and Vascular Neurology Dec 2018, svn-2018-000187; DOI: 10.1136/svn-2018-000187
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