In discussions with the silk road executive medical director, the extravasation being reported was due to a series of events.First, the lesion that was to be treated was highly calcified and not suitable for stenting.Second, the post-dilatation was very aggressive, forcing the stent against the calcified lesion.The end result was extravasation of the vessel.There have been only 8 extravasations reported in more than 16,000 transcarotid artery revascularization procedures.Complaint data will continue to be monitored for trends of extravasation.
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Patient underwent a left transcarotid artery revascularization.Patient had pre-dilatation with 6x30mm rapid exchange balloon followed by a successful delivery of a 10x40mm enroute stent.Following angiogram showed mild stenosis and post-dilatation was performed with 7x20mm rx balloon.Following angiogram showed extravasation of contrast at the distal portion of the stent.A 8x39mm gore viabahn vbx balloon expandable stent was placed at the distal portion of the enroute stent with approximately 1 cm overlap.Following angiogram showed improvement of extravasation.Patient woke up post-operatively at baseline mental status, following all verbal commands as well as moving all extremities appropriately to verbal commands.Follow up with surgeon the following morning, he reported the patient to be doing well with mild confusion which he attributed to her advanced age.
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