Ischemic preconditioning during the use of the PercuSurge occlusion balloon for carotid angioplasty and stenting

Peter L. Faries, Brian DeRubertis, Susan Trocciola, John K Karwowski, K. Craig Kent, Rabih A. Chaer

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Ischemic preconditioning (IP) uses transient ischemia to render tissues tolerant to subsequent, prolonged ischemia. This study sought to evaluate factors that contributed to the development of cerebral ischemia during PercuSurge balloon (Medtronic, Santa Rosa, CA) occlusion in patients undergoing carotid angioplasty and stenting (CAS). The PercuSurge occlusion balloon was used in 43 of 165 patients treated with CAS for high-grade stenosis; 20% were symptomatic. Symptoms of cerebral hypoperfusion during temporary occlusion of the internal carotid artery occurred in 10 of 43 patients and included dysarthria, agitation, decreased level of consciousness, and focal hemispheric deficit. The development of neurologic symptoms after initial PercuSurge balloon inflation and occluded internal carotid artery flow was associated with a decrease in the mean Glasgow Coma Scale (GCS) from 15 to 10 (range 9-14); the GCS returned to normal after occlusion balloon deflation. The mean time to spontaneous recovery of full neurologic function was 8 minutes (range 4-15 minutes). The mean subsequent procedure duration was 11.9 minutes (range 6-21 minutes). No recurrence of neurologic symptoms occurred when the occlusion balloon was reinflated. All 10 patients underwent successful CAS without occlusion, dissection, cerebrovascular accident, or death. Ischemic preconditioning can be used to enable CAS with embolic protection in patients who cannot tolerate initial interruption of antegrade cerebral perfusion by PercuSurge occlusion.

Original languageEnglish (US)
Pages (from-to)1-9
Number of pages9
JournalVascular
Volume16
Issue number1
DOIs
StatePublished - Jan 2008
Externally publishedYes

Fingerprint

Ischemic Preconditioning
Balloon Angioplasty
Angioplasty
Balloon Occlusion
Glasgow Coma Scale
Internal Carotid Artery
Neurologic Manifestations
Ischemia
Dysarthria
Economic Inflation
Brain Ischemia
Consciousness
Nervous System
Dissection
Pathologic Constriction
Perfusion
Stroke
Recurrence

Keywords

  • Angioplasty
  • Carotid
  • Ischemic preconditioning
  • PercuSurge
  • Stenting

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging
  • Surgery

Cite this

Faries, P. L., DeRubertis, B., Trocciola, S., Karwowski, J. K., Kent, K. C., & Chaer, R. A. (2008). Ischemic preconditioning during the use of the PercuSurge occlusion balloon for carotid angioplasty and stenting. Vascular, 16(1), 1-9. https://doi.org/10.2310/6670.2008.00012

Ischemic preconditioning during the use of the PercuSurge occlusion balloon for carotid angioplasty and stenting. / Faries, Peter L.; DeRubertis, Brian; Trocciola, Susan; Karwowski, John K; Kent, K. Craig; Chaer, Rabih A.

In: Vascular, Vol. 16, No. 1, 01.2008, p. 1-9.

Research output: Contribution to journalArticle

Faries, PL, DeRubertis, B, Trocciola, S, Karwowski, JK, Kent, KC & Chaer, RA 2008, 'Ischemic preconditioning during the use of the PercuSurge occlusion balloon for carotid angioplasty and stenting', Vascular, vol. 16, no. 1, pp. 1-9. https://doi.org/10.2310/6670.2008.00012
Faries, Peter L. ; DeRubertis, Brian ; Trocciola, Susan ; Karwowski, John K ; Kent, K. Craig ; Chaer, Rabih A. / Ischemic preconditioning during the use of the PercuSurge occlusion balloon for carotid angioplasty and stenting. In: Vascular. 2008 ; Vol. 16, No. 1. pp. 1-9.
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