Introduction Accounting for 87% of all types of stroke, ischemic stroke has both fatal and disabling consequences for affected patients. Ischemic stroke remains the leading cause of long-term disability; however, technologic and therapeutic advances made in the past decade offer…
Introduction Since the initial introduction of endovascular coiling techniques by Guglielmi in 1991, endovascular therapies for intracranial aneurysms have evolved. Initially, intrasaccular coiling and parent vessel occlusion with coils after balloon test occlusion were the mainstays of treatment. At the…
Introduction Intracranial atherosclerotic disease (ICAD) is defined as atherosclerosis of the large intracranial arteries, namely the intracranial internal carotid artery (ICA), intracranial vertebral and basilar arteries, middle, anterior and posterior cerebral arteries, and their cortical branches (up to M3, A3,…
Introduction Intracranial arteriovenous malformations (AVM) are a demanding pathology to treat. There is ample discussion about which single modality or which amalgam of modalities is the most optimal, i.e., endovascular embolization, microsurgical resection, or radiosurgery. The discussion also extends to…
Introduction Subclavian steal phenomenon (or syndrome) originates from severe stenosis or occlusion of the proximal subclavian artery resulting in the reversal of blood flow in the ipsilateral vertebral artery (VA) to perfuse the limb. Blood flows retrogradely from the brain…
Extracranial carotid artery occlusive disease is associated with the risk of stroke, disability, and death. The surgical treatment of carotid disease has undergone significant evolution from early attempts at carotid ligation to the first carotid endarterectomy by Michael Debakey in…
Introduction The Carotid Wallstent (Boston Scientific, Marlborough, MA) is one of the most used stents in the endovascular treatment of carotid stenosis, particularly because of its design, which allows excellent plaque coverage. For that reason, it seems adequate for the…
Introduction The use of carotid artery stenting to treat carotid bifurcation stenosis remains a topic of recent investigation and vigorous debate regarding safety and efficacy. Multiple prospective randomized controlled trials have compared carotid endarterectomy (CEA) with carotid artery stenting (CAS)…
Introduction Stenting of supra-aortic vessels has become a reasonable alternative or sometimes the treatment of choice for cases of athero-occlusive disease of the carotid, subclavian, innominate, and vertebral arteries. Protection from distal embolic debris or thrombus remains critical while performing…
Introduction Interventionalists are especially cautious with carotid artery stenting (CAS) because complications can lead to devastating and permanent neurological sequelae, even death. Preparation for CAS can often seem excessive; however, careful and detailed planning is the key to circumvent unwanted…