From new techniques to evolving best practices–are you up to date with the latest developments in carotid artery stenting? In this episode, Dr. Wayne Olan, Interventional Neuroradiologist and the director of Minimally Invasive Neurosurgery at George Washington University joins Dr. Michael Barraza for a discussion on the latest innovations and evolving techniques in carotid artery stenting.
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SYNPOSIS
Dr. Olan opens the conversation with a historical perspective on the evolution of carotid stenting, tracing advancements from early techniques to modern devices. He then talks through referral patterns, noting that the majority originate from cardiologists. Dr. Olan emphasizes the importance of meticulous periprocedural planning and comprehensive post-procedural management. Central to this discussion is the critical role of antiplatelet therapy, including strategies for addressing Plavix non-responders, such as the use of Integrilin.
The discussions also covers advanced techniques in carotid artery stenting, including the utilization of the Aptus sheath and the Contego stent system. He underscores the importance of mastering the available tools, understanding patient-specific factors, meticulous procedural planning, and always maintaining a contingency plan. He concludes the discussion by exploring emerging trends and the future potential of outpatient carotid stenting.
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TIMESTAMPS
00:00 - Introduction
02:44 - The Importance of Stroke Intervention
07:16 - Carotid Stenting: Evolution and Techniques
13:29 - Challenges and Collaborations in Carotid Interventions
16:17 - Technical Insights and Best Practices
25:24 - Choosing the Right Wire for Carotid Procedures
25:53 - Anticoagulation and Filter Wire Techniques
28:30 - Managing Stent Placement and Distal Protection
30:54 - Handling Carotid Bifurcation and Skull Base Lesions
38:43 Dealing with Tandem Occlusions
42:06 - Future Trends in Outpatient Procedures
44:43 - Addressing Re-stenosis and Vertebral Lesions
45:44 - Conclusion and Final Thoughts
