Carotid
CAS

Carotid artery stenting for post radiation stenosis

How would you treat the case of this 76-year-old man: endovascular or open surgery?

Éric Ducasse
Éric Ducasse
Hospital Pellegrin - Bordeaux, France
Professor of vascular surgery

Professor of vascular surgery
Head of unit of vascular surgery CHU Bordeaux - France

Conflicts of interest:

Honoraria from: COOK Médical, Térumo-Vascutek, Siemens, GORE

Medical history

Mr M. 76 a

  • Larynx carcinoma treated by Radiotherapy and  Chemotherapy 2020
  • Aorto – bi iliac bypass
  • Pre-thrombotic stenosis of left intern carotid
Initial angiogram
ANGIOGUARD™ RX Embolic Protection Device
ANGIOGUARD™ RX Embolic Protection Device
Recommendation 87 & 88
Pre dilatation with Viatrac D. 4 mm
Recommendation 85
Recommendation 81
Post dilatation arteriography
CGUARD™ Carotid Embolic Prevention System
CGUARD™ Carotid Embolic Prevention System
Stenting: 8*40 mm
Final control

Gestion of antiplatelet

Recommendation 12
ESVS 2023 Clinical Practice Guidelines on the Management of Atherosclerotic Carotid and Vertebral Artery Disease