OBJECTIVE: To observe the feasibility and safety of @entity3538 ( @entity3538 ) for high-grade extracranial @entity543 combined with severe tortuosity. METHODS: Twenty @entity1 diagnosed with high-grade extracranial @entity543 combined with severe tortuosity by cerebral angiography, who were in hospital in neurology department of China-Janpan friendship from June 2011 to June 2014. Twelve of these @entity1 were symptomatic. All cases weren't suit for or disagreed with carotid endarterectomy (CEA) to accept @entity3538 . We retrospectively discussed the rates of technical success, the perioperative complications and clinical improvement. During the follow-up for 4 to 40 months we observed the events of cured carotid artery territory @entity64 and @entity204 , and record the @entity1373 in stent, in-stent restenosis, stent deformation or @entity174 by color doppler ultrasonography or craniocervical CT angiography. RESULTS: (1) The results of operation: the rate of technical success was 19/20 and the rate of the distal protection device placement was 18/20. One stent and 2 distal protection device were difficult to pass the tortuous access vessels. The kinking was the most common in circuity classification of internal carotid artery. The @entity850 was significantly improved after stenting, and the mean degree of @entity850 was reduced from (82%    9%) before stenting to (7%    6%) after stenting. Although 5 @entity1 were with perioperative complications, all symptoms disappeared within 1 weeks, and there was no stent related @entity204 and disability. There were 4 cases with @entity2553 , one of them was combined with carotid sinus reaction, and anther with @entity63 ( @entity63 ) during operation. There was one with ipsilateral carotid territory minor @entity64 . (2) The results of prognosis and follow up: The clinical symptoms from 12 symptomatic @entity1 were improved significantly on discharge, and the average NIHSS scores on admission were reduced from (4    4) to (2    2) on discharge. One @entity1 experienced ipsilateral carotid territory minor @entity64 and another @entity1 experienced ipsilateral carotid territory @entity63 during the follow-up for an average of 19 months, and there were 5 cases with mild @entity1373 in stent and no in-stent restenosis, stent deformation or @entity174 . CONCLUSION: The severe tortuosity of extracranial carotid artery may affect the using of intervention materials and increase the complexity of @entity3538 , but for the @entity1 who disagree with CEA or were with the contraindications to CEA, @entity3538 may be still a relatively safe, effective and alternative treatment.

[Clinical analysis of XXXX for high-grade extracranial @entity543 combined with severe tortuosity].

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity64 :: ('MESH:D020521', 'Disease') :: ['stroke'] @entity174 :: ('MESH:D050723', 'Disease') :: ['fracture'] @entity63 :: ('MESH:D007511', 'Disease') :: ['TIA', 'transient ischemic attack'] @entity3538 :: ('MESH:D002341', 'Disease') :: ['carotid angioplasty stenting', 'CAS'] @entity1373 :: ('MESH:D006965', 'Disease') :: ['plaque hyperplasia'] @entity2553 :: ('MESH:D020301', 'Disease') :: ['vascular spasm'] @entity850 :: ('MESH:D003251', 'Disease') :: ['stenosis'] @entity543 :: ('MESH:D016893', 'Disease') :: ['carotid artery stenosis'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death']
@entity3538 :: (MESH:D002341,Disease) :: ['carotid angioplasty stenting']
