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European Surgery
Erschienen in:

01.12.2014 | Main Topic

Management of atherosclerotic supraaortic lesions

verfasst von: K. Linni, MD, M. Aspalter, MD, P. Metzger, MD, Prof. H. Magometschnigg, Prof. T. Hölzenbein

Erschienen in: European Surgery | Ausgabe 6/2014

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Abstract

Background

Prevention of cerebrovascular ischemic lesions due to atherosclerotic occlusive disease (AOD) of supraaortic vessels plays a major role in the daily workload of a vascular surgeon. The aim of this study was to give an overview of current endovascular and surgical treatment options for patients suffering from internal carotid artery (ICA), vertebral artery (VA), proximal subclavian artery (SA), and common carotid artery (CCA) AOD within a modern multidisciplinary management concept.

Methods

A systemic review of the literature on management of supraaortic AOD was undertaken. Medline (1995–2014) and Cochrane Electronic Databases (2014) were searched for publications dealing with surgical and endovascular treatment of ICA, VA, SA, and/or CCA lesions, respectively.

Results

ICA stenosis is the most common supraaortic lesion and is regarded as an indicator for endarterectomy (eversion or standard) in both symptomatic and asymptomatic patients. Percutaneous transluminal angioplasty (PTA) with stent should be restricted to patients with hostile neck, contralateral laryngeal nerve palsy, high-grade restenosis, or very distal ICA stenosis. Other supraaortic lesions like VA, SA, and CCA stenosis/occlusion were initially operated via a transthoracic approach but high complication rates brought extrathoracic surgical techniques forward. Since the 1980s PTA with its minimally invasive character and its progressive stent technology has become the treatment of choice for patients with VA, SA, or CCA lesions.

Conclusions

Primary ICA stenosis should be treated by endarterectomy first. All other supraaortic lesions should be managed endovascularly but surgery poses a good treatment alternative if endovascular management fails or is contraindicated.
Vorheriger Artikel Postoperative blood pressure in patients undergoing eversion carotid endarterectomy with or without resection of the carotid sinus nerve
Nächster Artikel The all autologous vein policy in infrainguinal bypass surgery
Literatur
1.
North American Symptomatic Carotid Endarterectomy Trial Collaborators. Beneficial effect of carotid endartectomy in symptomatic patients with high-grade carotid stenosis. N Eng J Med. 1991;325:445–53.CrossRef
2.
Haghighi AB, Edgell RC, Cruz-Flores S, Zaidat OO. Vertebral artery origin stenosis and its treatment. J Stroke Cerebrovasc Dis. 2011;20(4):369–76.CrossRef
3.
Wityk RJ, Chang HM, Rosengart A, et al. Proximal extracranial vertebral artery disease in the New England Medical Center Posterior Circulation Registry. Arch Neurol. 1998;55:470–8.PubMedCrossRef
4.
Kieffer E, Praquin B, Chiche L, Koskas F, Bahnini A. Distal vertebral artery reconstruction: Long-term outcome. J Vasc Surg. 2002;36:549–54.PubMedCrossRef
5.
Clair DG, Greenberg RK. Diagnosis and treatment of proximal carotid lesions. Semin Vasc Surg. 2000;13(2):103–8.PubMed
6.
Czerny M, Zimpfer D, Rödler S, et al. Endovascular stent–graft placement of aneurysms involving the descending aorta originating from chronic type B dissections. Ann Thorac Surg. 2007;83:1635–9.PubMedCrossRef
7.
Crawford ES, DeBakey ME, Morris GC, Cooley DA. Thromboobliterative disease of the great vessels arising from the aortic arch. J Thorac Cardiovasc Surg. 1962;43:38–53.PubMed
8.
Bachman DM, Kim RM. Transluminal dilatation for subclavian steal syndrome. Am J Roentgenol. 1980;135:995–6.CrossRef
9.
Selim MH, Molina CA. Medical versus surgical treatment of asymptomatic carotid stenosis: the ever-changing nature of evidence-based medicine. Stroke. 2011;42:1156–7.PubMedCrossRef
10.
European Carotid Surgery Trialists’ Collaborative Group. Randomised trial of endarterectomy for recently symptomatic carotid stenosis: final results of the MRC European Carotid Surgery Trial (ECST). Lancet. 1998;351:1379–87.CrossRef
11.
Executive Committee for the Asymptomatic Carotid Atherosclerosis Study. Endarterectomy for asymptomatic carotid artery stenosis. JAMA. 1995;273:1421–8.CrossRef
12.
Asymptomatic Carotid Surgery Trial Collaborators. The MRC Asymptomatic Carotid Surgery Trial (ACST): carotid endarterectomy prevents disabling and fatal carotid territory strokes. Lancet. 2004;363:1491–502.CrossRef
13.
Gray W. ARCHeR Trial Investigators. Two-year composite endpoint results for the ARCHeR trial: ACCULINK for revascularization of carotids in high risk patients. Am Heart J. 2004;94(Suppl):62E.
14.
Alberts MJ. WALLSTENT. Results of a multicenter prospective randomized trial of carotid artery stenting versus carotid endarterectomy (abstract). Stroke. 2001;32:325.CrossRef
15.
Mas JL, Chatellier G, Beyssen B, et al. Endarterectomy versus stenting in patients with severe symptomatic stenosis. N Engl J Med. 2006;355:1660–71.PubMedCrossRef
16.
CAVATAS Investigators. Endovascular versus surgical treatment in patients with carotid stenosis in the carotid and vertebral artery transluminal angioplasty study (CAVATAS): a randomised trial. Lancet. 2001;357:1729–37.CrossRef
17.
Yadav JS, Wholey MH, Kuntz RE, et al. Protected carotid-artery stenting versus endarterectomy in high-risk patients. N Engl J Med. 2004;351:1493–501.PubMedCrossRef
18.
Bell P. Limitations to the value of the Sapphire trial. Acta Chir Belg. 2006;106:141–3.PubMed
19.
Domenig C, Hölzenbein T. Selected commentary to “Protected carotid-artery stenting versus endarterectomy in high-risk patients” Eur Surg. 2005;37(2):107–9.CrossRef
20.
SPACE Collaborators. Stent protected angioplasty versus carotid endarterectomy in symptomatic patients: 30 days results from the SPACE Trial. Lancet. 2006;368:1239–47.CrossRef
21.
Brott TG, Hobson RW II, Howard G, et al. CREST Investigators. Stenting versus endarterectomy for treatment of carotid-artery stenosis. N Engl J Med. 2010;363:11–23.PubMedCentralPubMedCrossRef
22.
International Carotid Stenting Study Investigators. Carotid artery stenting compared with endarterectomy in patients with symptomatic carotid stenosis (International Carotid Stenting Study): an interim analysis of a randomized controlled trial. Lancet. 2010;375:985–97. (Erratum in Lancet. 2010;376:90)PubMedCentralCrossRef
23.
Qureshi AI, Kirmani JF, Divani AA, Hobson RW 2nd. Carotid angiolasty with or without stent placement versus carotid endarterectomy for treatment of carotid stenosis: a meta-analysis. Neurosurgery. 2005;56:1171–9.PubMedCrossRef
24.
Omlor G, Schröder J, Müller M, Behnke S, Lindemann W, Meyer A. Optimierung der Ergebnisse nach Karotis-TEA durch „No-touch-isolation-Technik“ und intraoperative Angiographie. Gefässchirurgie. 2000;5:99–104.CrossRef
25.
Stanziale SF, Marone LK, Boules TN, et al. Carotid artery stenting in octogenarians is associated with increased adverse outcomes. J Vasc Surg. 2006;43:297–304.PubMedCrossRef
26.
Lam RC, Lin SC, DeRubertis B, Hynecek R, Kent KC, Faries PL. The impact of increasing age on anatomic factors affecting carotid angioplasty and stenting. J Vasc Surg. 2007;45:875–80.PubMedCrossRef
27.
Mlekusch W, Schillinger M, Sabeti S, et al. Hypotension and bradycardia after elective carotid stenting: frequency and risk factors. J Endovasc Ther. 2003;10:851–61.PubMedCrossRef
28.
Jordan WD Jr, Voellinger DC, Doblar DD, Plyuscheva NP, Fisher WS, McDopwell HA. Microemboli detected by transcranial Doppler monitoring in patients during carotid angioplasty versus carotid endarterctomy. Cardiovasc Surg. 1999;7:33–48.PubMedCrossRef
29.
Gossetti B, Gattuso R, Irace L, et al. Embolism to the brain during carotid stenting and surgery. Acta Chir Belg. 2007;107:151–4.PubMed
30.
Czerny M, Schuch P, Sodeck G, et al. Sustained cognitive benefit 5 years after carotid endarterecomy. J Vasc Surg. 2010;51(5):1139–44.PubMedCrossRef
31.
Ferguson GG, Eliasziw M, Barr HWK, et al. The North American Symptomatic Carotid Endarterectomy Trial: surgical results in 1415 patients. Stroke. 1999;30(9):1751–8.PubMedCrossRef
32.
Yavin D, Roberts DJ, Tso M, Sutherland GR, Eliasziw M, Wong JH. Carotid endarterectomy versus stenting: a meta-analysis of randomized trials. Can J Neurol Sci. 2011;38:230–5.PubMedCrossRef
33.
Jordan WD, Roye GD, Fisher WS, Redden D, McDowell HA. A cost comparison of balloon angioplasty and stenting versus endarterectomy for the treatment of carotid artery stenosis. J Vasc Surg. 1998;27:16–24.PubMedCrossRef
34.
Gray WA, White HJ Jr, Barrett DM, Chandran G, Turner R, Reisman M. Carotid stenting and endarterctomy: a clinical and cost comparison of revascularization strategies. Stroke. 2002;33:1063–70.PubMedCrossRef
35.
Park B, Mavanur A, Dahn M, Menzoian J. Clinical outcomes and cost comparison of carotid artery angioplasty with stenting versus carotid endarterctomy. J Vasc Surg. 2006;44:270–6.PubMedCrossRef
36.
Kilaru S, Korn P, Kasirajan K, et al. Is carotid angioplasty and stenting more cost effective than carotid endarterectomy. J Vasc Surg. 2003;37:331–9.PubMedCrossRef
37.
Young KC, Holloway RG, Burgin WS, Benesch CG. A cost-effectiveness analysis of carotid artery stenting compared with endarterectomy. J Stroke Cerebrovasc Dis. 2010;19(5):404–9.PubMedCentralPubMedCrossRef
38.
Reigner B, Reveilleau P, Gayral M, Papon X, Enon B, Chevalier JM. Eversion endarterectomy of the internal carotid artery: mid-term results of a new technique. Ann Vasc Surg. 1995;9:141–6.CrossRef
39.
Mehta M, Rahmani O, Dietzek AM, et al. Eversion technique increases the risk of post-carotid endarterectomy hypertension. J Vasc Surg. 2001;34(5):839–45.PubMedCrossRef
40.
Demirel S, Bruijnen H, Attigah N, Hakimi M, Böckler D. The effect of eversion and conventional-patch technique in carotid surgery on postoperative hypertension. J Vasc Surg. 2011;54(1):80–6.PubMedCrossRef
41.
Linni K, Mader N, Hölzenbein Th. Competitive strategies for surgery in the treatment of primary internal carotid artery (ICA) stenosis. Eur Surg. 2008;40(5):227–38.CrossRef
42.
Brott TG, Halperin JL, Abbara S, et al. ASA/ACCF/AHA/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS Guideline on the management of patients with extracranial carotid and vertebral artery disease. A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, and the American Stroke Association, American Association of Neuroscience Nurses, American Association of Neurological Surgeons, American College of Radiology, American Society of Neuroradiology, Congress of Neurological Surgeons, Society of Atherosclerosis Imaging and Prevention, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of NeuroInterventional Surgery, Society for Vascular Medicine, and Society for Vascular Surgery. Developed in collaboration with the American Academy of Neurology and Society of Cardiovascular Computed Tomography. J Am Coll Cardiol. 2011;57:e16–94.PubMedCrossRef
43.
Moufarrij NA, Little JR, Furlan AJ, Williams G, Marzewski DJ. Vertebral artery stenosis: long-term follow-up. Stroke. 1984;15:260–3.PubMedCrossRef
44.
Cate WR, Scott HW Jr. Cerebral ischemia of central origin: Relief by subclavian-vertebral artery thrombendarterectomy. Surgery. 1959;45:19–30.PubMed
45.
Berguer R. Vertebrobasilar ischemia: indications, techniques, and results of surgical repair. In: Vascular Surgery. 5th ed. Philadelphia: W.B. Saunders Company; 2000. pp. 1823–37.
46.
Berguer R, Flynn LM, Kline RA, Caplan L. Surgical reconstruction of the extracranial vertebral artery: management and outcome. J Vasc Surg. 2000;31:9–18.PubMedCrossRef
47.
Picquet J, Benharash P, Blin V, Jousset Y, Papon X, Enon B. Surgery of the pretransversal vertebral artery: indications and results. Int Angiol. 2007;26:279–84.PubMed
48.
Diaz FG, Ausman JI, de los Reyes RA, et al. Surgical reconstruction of the proximal vertebral artery. J Neurosurg. 1984;61:874–81.PubMedCrossRef
49.
Linni K, Aspalter M, Magometschnigg H, Hölzenbein T. Long-term neurologic outcome and durability of proximal vertebral artery reconstructions. Chirurgia. 2011;24:257–62.
50.
Motarjeme A, Keifer JW, Zuska AJ. Percutaneous transluminal angioplasty of the vertebral arteries. Radiology. 1981;139:715–7.PubMedCrossRef
51.
Storey GS, Marks MP, Dake M, Norbash AM, Steinberg GK. Vertebral artery stenting following percutaneous transluminal angioplasty. Technical note. J Neurosurg. 1996;84:883–7.PubMedCrossRef
52.
Eberhardt O, Naegele T, Raygrotzki S, Weller M, Ernemann U. Stenting of vertebrobasilar arteries in symptomatic atherosclerotic disease and acute occlusion: case series and review of the literature. J Vasc Surg. 2006;43:1145–54.PubMedCrossRef
53.
Berguer R, Morasch MD, Kline RA. A review of 100 consecutive reconstructions of the distal vertebral artery for embolic and hemodynamic disease. J Vasc Surg. 1998;27:852–9.PubMedCrossRef
54.
Thevenet A, Ruotolo C. Surgical repair of vertebral artery stenoses. J Cardiovasc Surg (Torino). 1984;25:101–10.PubMed
55.
Edwards WH, Mulherin JL. The surgical reconstruction of the proximal subclavian and vertebral artery. Ann Vasc Surg. 1985;2:634–9.CrossRef
56.
Malek AM, Higashida RT, Phatouros CC, et al. Treatment of posterior circulation ischemia with extracranial percutaneous ballon angioplasty and stent placement. Stroke. 1999;30:2073–85.PubMedCrossRef
57.
Shadman R, Criqui MH, Bundens WP, et al. Subclavian artery stenosis: prevalence, risk factors, and association with cardiovascular diseases. J Am Coll Cardiol. 2004;44:618–23.PubMedCrossRef
58.
59.
Crawford ES, De Bakey ME, Morris GC, Howell JF. Surgical treatment of occlusion of the innominate, common carotid, and subclavian arteries: a 10 year experience. Surgery. 1969;65:17–31.PubMed
60.
Domenig C, Linni K, Mader N, Kretschmer G, Magometschnigg H, Hölzenbein TJ. Subclavian to carotid artery transposition (SCT): medial versus lateral approach. Eur J Vasc Endovasc Surg. 2008;35(5):551–7.PubMedCrossRef
61.
Harjola PT, Valle M. The importance of aortic arch or subclavian angiography before coronary reconstruction. Chest. 1974;66:436–8.PubMedCrossRef
62.
Kretschmer G, Teleky B, Marosi L, et al. Obliterations of the proximal subclavian artery: To bypass or to anastomose? J Cardiol Surg. 1991;32:334–9.
63.
Sandmann W, Kniemeyer HW, Jaeschock R, Hennerici M, Aulich A. The role of subclavian-carotid transposition in surgery for supra-aortic occlusive disease. J Vasc Surg. 1987;5:53–8.PubMedCrossRef
64.
Schardey HM, Meyer G, Rau HG, Gradl G, Jauch KW, Lauterjung L. Subclavian-carotid transposition: An analysis of a clinical series and a review of the literature. Eur J Vasc Endovasc Surg. 1996;12:431–6.PubMedCrossRef
65.
Linni K, Ugurluoglu A, Mader N, Hitzl W, Magometschnigg H, Hölzenbein Th. Endovascular management versus surgery for proximal subclavian artery lesions. Ann Vasc Surg. 2008;22:769–75.PubMedCrossRef
66.
Cina C, Safar H, Lagana A, Arena G, Clase CM. Subclavian carotid transposition and bypass grafting: consecutive cohort study and systematic review. J Vasc Surg. 2002;35:422–9.PubMedCrossRef
67.
Queral LA, Criado FJ. The treatment of focal aortic arch branch lesions with Palmaz stents. J Vasc Surg. 1996;23:368–75.PubMedCrossRef
68.
Motarjeme A, Keifer JW, Zuska AJ, Nabani P. Percutaneous transluminal angioplasty for treatment of subclavian steal. Radiology. 1985;155:611–3.PubMedCrossRef
69.
Selby JB, Matsumoto AH, Tegtmeyer CJ, et al. Balloon angioplasty above the aortic arch: intermediate and long term results. AJR Am J Roentgenol. 1993;160:631–5.PubMedCrossRef
70.
Rodriguez-Lopez JA, Werner A, Martinez R, Torruella LJ, Ray LI, Diethrich EB. Stenting for atherosclerotic occlusive disease of the subclavian artery. Ann Vasc Surg. 1999;13:254–60.PubMedCrossRef
71.
72.
De Vries JP, Jager LC, Van den Berg JC, et al. Durability of percutaneous transluminal angioplasty for obstructive lesions of proximal subclavian artery: long-term results. J Vasc Surg. 2005;41:19–23.PubMedCrossRef
73.
Farina C, Mingoli A, Schultz RD, et al. Percutaneous transluminal angioplasty versus surgery for subclavian artery occlusive disease. Am J Surg. 1989;158:511–4.PubMedCrossRef
74.
AbuRahma AF, Bates MC, Stone PA, et al. Angioplasty and stenting versus carotid-subclavian bypass for the treatment of isolated subclavian artery disease. J Endovasc Ther. 2007;14:698–704.PubMedCrossRef
75.
Dietrich EB, Garrett HE, Ameriso J, Crawford ES, El-Bayer M, DeBakey ME. Occlusive disease of the common carotid and subclavian arteries treated by carotid-subclavian bypass. Am J Surg. 1967;114:800–8.CrossRef
76.
Linni K, Aspalter M, Ugurluoglu A, Hölzenbein T. Proximal common carotid artery lesions: endovascular and open repair. Eur J Vasc Endovasc Surg. 2011;41(6):728–34.PubMedCrossRef
77.
Berguer R, Morasch MD, Kline RA, Kazmers A, Friedland MS. Cervical reconstruction of the supra-aortic trunks: A 16-year experience. J Vasc Surg. 1999;29(2):239–48.PubMedCrossRef
78.
Cull DL, Hansen JC, Taylor SM, Langan 3rd EM, Snyder BA, Coffey CB. Internal carotid artery patency following common carotid artery occlusion: management of the asymptomatic patient. Ann Vasc Surg. 1999;13:73–6.PubMedCrossRef
79.
Shimizu K, Sano K. Pulseless disease. J Neuropathol Clin Neurol. 1951;1:37–47.
80.
Berguer R, Kieffer R, editors. Surgery of the arteries to the head. New York: Springer Verlag New York Inc;1992.
81.
Moore WS, Blaisdell W, Hall AD. Retrograde thrombectomy for chronic occlusion of the common carotid artery. Arch Surg. 1967;95:664–73.PubMedCrossRef
82.
Owens LV, Tinsley EA Jr, Criado E, Burnham S, Keagy BA. Extrathoracic reconstruction of arterial occlusive disease involving the supraaortic trunks. J Vasc Surg. 1995;22(3):217–22.PubMedCrossRef
83.
Archie JP. Axillary-to-carotid artery bypass grafting for symptomatic severe common carotid artery occlusive disease. J Vasc Surg. 1999;30:1106–12.PubMedCrossRef
84.
Allie DE, Hebert CJ, Lirtzman MD, et al. Intraoperative innominate and common carotid intervention combined with carotid endarterectomy: a “true” endovascular approach. J Endovasc Ther. 2004;11:258–62.PubMedCrossRef
85.
Levien LJ, Benn CA, Veller MG, Fritz VU. Retrograde balloon angioplasty of brachiocephalic or common carotid artery stenoses at the time of carotid endarterectomy. Eur J Vasc Endovasc Surg. 1998;15(6):521–7.PubMedCrossRef
86.
Sullivan TM, Gray B, Bacharach JM, et al. Angioplasty and primary stenting of the subclavian, innominate, and common carotid arteries in 83 patients. J Vasc Surg. 1998;28(6):1059–65.PubMedCrossRef
87.
Paukovits TM, Haasz J, Molnar A, et al. Transfemoral endovascular treatment of proximal common carotid artery lesions: a single-center experience on 153 lesions. J Vasc Surg. 2008;48(1):80–7.PubMedCrossRef
88.
Chio FL Jr, Liu MW, Khan MA, Iyer SS, Roubin GS. Effectiveness of elective stenting of common carotid artery lesions in preventing stroke. Am J Cardiol. 2003;92(9):1135–7.PubMedCrossRef
89.
Takach TJ, Duncan JM, Livesay JJ, et al. Brachiocephalic reconstruction II: Operative and endovascular management of single-vessel disease. J Vasc Surg. 2005;42(1):55–61.PubMedCrossRef
Metadaten
Titel
Management of atherosclerotic supraaortic lesions
verfasst von
K. Linni, MD
M. Aspalter, MD
P. Metzger, MD
Prof. H. Magometschnigg
Prof. T. Hölzenbein
Publikationsdatum
01.12.2014
Verlag
Springer Vienna
Erschienen in
European Surgery / Ausgabe 6/2014
Print ISSN: 1682-8631
Elektronische ISSN: 1682-4016
DOI
https://doi.org/10.1007/s10353-014-0268-6

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