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SuriHome about back issues search submit article contact asum minnis journals ajum volume 13 issue 3 august 2010 ajum august 2010; 13 (3):20-22 view article as pdf carotid duplex ultrasound after carotid stenting john swinnen department of vascular surgery, westmead hospital, westmead, new south wales 2145, australia. Correspondence to john swinnen via asum. Email authors@asum. Com. Au keywords carotid duplex ultrasound, carotid stenosis, introduction duplex ultrasound (us) of the carotid arteries after carotid stenting is significantly different from the examination of an unoperated vessel or from the study following carotid endarterectomy. The differences lie in the features examined and reported, but more importantly, in the criteria used to define carotid stenosis. Nature of the scan generally, a follow-up scan after a carotid stenting procedure is performed for the surveillance of the stent, not for monitoring of the untreated contralateral carotid. Hence, if the contralateral artery is not significantly stenosed, we perform ipsilateral scans only (i. how long does viagra take to have effect E. “targeted us”). Since the distal/cephalic end of the carotid stent can be placed well distal/cephalic to the point accessible at open carotid endarterectomy, duplex us after carotid stenting often requires the use of a sector probe to visualise the distal end of the stent and the internal carotid artery (ica) beyond it. viagra online paypal This is particularly true in that one of the strong indications for carotid stenting (as opposed to endarterectomy) is the presence of a high carotid bifurcation, placing the distal end of the stent even closer to the skull base. buy generic viagra online Finally, the timing of the scan in relationship to the date of the carotid stenting operation has an important bearing on the type of stenosis encountered. Stenoses in the stented carotid artery it is important to appreciate how “stenosis” is defined in the ica and also the different “types” of stenoses encountered after carotid stenting, as well as their timing and their nature. The landmark studies, nascet1 and ecst2, used different definitions of carotid stenosis fig. purchase generic viagra 1. Nascet used the more logical distal, normal ica as the denominator, whereas ecst used the diameter of the bulb. buy viagra online 25mg These were based of course, on angiographic assessments of stenosis. It is my practice when assessing in-stent stenosis with gray scale and colour us after carotid stenting to use the nascet system – i. usa generic viagra E. I compare the diameter of the most stenosed part of the stent to the diameter of the stent in a “normal” part of the ica or the more distal ica. Fig. 2. buy viagra online 25mg Illustrates the different types of stenoses encountered after carotid stenting, their timing and aetiology. Fig. viagra without a doctor prescription 2a shows the “original carotid stenosis” requiring treatment. Fig. 2b shows the “completion residual stenosis” i. E. The residual stenosis still present at the end of the procedure on the final angiographic run. Note that in a carotid stenting procedure, we do not aim for angiographic perfection - this. generic viagra without prescription : Stands, Corners, Apliaciones Gráficas.
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