Patient Selection Warnings
Lesion Characteristics: Patients with evidence of intraluminal thrombus thought to increase the risk of plaque fragmentation and distal embolization. Patients whose lesion(s) may require more than two stents. Patients with total occlusion of the target vessel. Patients with highly calcified lesions resistant to PTA. Concurrent treatment of bilateral lesions.
Access Characteristics: Patients with known peripheral vascular, supra-aortic or internal carotid artery tortuosity that would preclude the use of catheter-based techniques. Patients in whom femoral or brachial arterial access is not possible
Patient Characteristics: Patients experiencing acute ischemic neurologic stroke or who experienced a large stroke within 48 hours. Patients with an intracranial mass lesion (i.e., abscess, tumor, or infection) or aneurysm (>9mm). Patients with arterio-venous malformations of the territory of the target carotid artery. Patients with coagulopathies. Patients with poor renal function, who, in the physician’s opinion, may be at high-risk for a reaction to contrast medium. Pregnant patients or patients under the age of 18.
Read more about this topic: Carotid Stenting
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—Mary Kay Blakely (20th century)