Barostim Implantation with Ipsilateral Carotid Endarterectomy as a One-Stage Procedure

Ann Vasc Surg. 2016 Oct:36:295.e9-295.e11. doi: 10.1016/j.avsg.2016.03.026. Epub 2016 Jul 15.

Abstract

Clinical trials have demonstrated significant and lasting reductions in arterial pressure from baroreflex activation therapy (BAT), resulting from electrical stimulation of the carotid sinus in patients with resistant arterial hypertension. Significant carotid atherosclerosis, however, has been a contraindication for ipsilateral implantation due to a potentially increased risk of periprocedural stroke and uncertain antihypertensive efficacy. Here, we describe the first case in which BAT was applied safely and effectively in a patient with distinct cerebral arteriosclerosis after ipsilateral carotid endarterectomy as a one-stage procedure without neurologic complications. BAT resulted in satisfactory blood pressure levels despite distinct cerebral atherosclerosis after an 18-month follow-up period.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Antihypertensive Agents / therapeutic use
  • Arterial Pressure* / drug effects
  • Baroreflex*
  • Carotid Stenosis / diagnostic imaging
  • Carotid Stenosis / surgery*
  • Electric Stimulation Therapy / instrumentation*
  • Endarterectomy, Carotid*
  • Humans
  • Hypertension / complications
  • Hypertension / diagnosis
  • Hypertension / physiopathology
  • Hypertension / therapy*
  • Implantable Neurostimulators*
  • Male
  • Pressoreceptors / physiopathology*
  • Prosthesis Design
  • Treatment Outcome

Substances

  • Antihypertensive Agents