Abstract
Carotid artery stenting (CAS) is usually performed using a contrast medium, but it is difficult to use in patients with a contrast agent allergy or renal dysfunction. In such cases, duplex-assisted CAS is performed without using a contrast agent. In general, the role of ultrasound in CAS includes evaluation of plaque properties, estimation of stenosis, confirmation of protrusion of plaque in the stent, and observation of blood flow change. In addition to the above assessments, duplex-assisted CAS plays an important role in various ways such as catheter tip guidance, determination of stent size, evaluation of distal protection, and change in blood flow before and after insertion of the stent. In addition, change in status during the procedure can be confirmed in real time, and protrusion of the thrombus in the stent can also be confirmed. Meanwhile, it is necessary to consider the examiners’ exposure to radiation, restrictions on the inspection field, extension of the ICA interruption time, how to position the ultrasound device, and how to hold the probe, and it is difficult to save still images when saving movies.
It is also necessary for the operator to be familiar with how to read the ultrasound images. As long as these aspects are considered, duplex-assisted CAS is a useful method.
