Supraaortik multiple stenozlarda eş zamanlı balon anjiyoplasti ve stent implantasyonu

Amaç: Bu çalışmanın amacı supraaortik çoklu stenotik lezyonlarda yapılan, eş zamanlı endovasküler tedavinin başarısı ile komplikasyonlarını değerlendirmektir.Gereç ve Yöntem: 1 Ocak-2004 ile 31 Aralık 2009 tarihler arasında supraaortik damar yatağında çoklu darlık nedeni ile perkütan girişimsel işlem uygulanan hastaların kayıtları geriye dönük incelendi. Doppler ultrasonografi, manyetik rezonans inceleme, bilgisayarlı tomografi veya dijital subtraksiyon anjiyografi ile supraaortik damarlarda %50 nin üzerinde darlık saptanması koşuluyla perkütan endovasküler girişim uygulanması kararı alındı. Klinik olarak en az 2 tane ciddi darlığı olan ve aynı seansta çoklu girişimsel işlem kararı verilen hastalar çalışmaya dahil edildi.Bulgular: Çalışmaya 6’sı kadın (%17,4) toplam 34 hasta (ortalama yaş 60,4±12,5) dahil edildi. Otuzdört hastada toplam 74 lezyona girişim uygulandı. Girişimlerin tamamında stent kullanıldı. Mortalite veya ciddi morbidite görülmedi. İşlemin teknik olarak akut başarısı %100’dü. Ortalama 29,5±18,3 aylık takipte, 4 hastada (%11,7) restenoz geliştiği görüldü. Bu hastalardan 3’üne tekrar girişim uygulandı.Sonuç: Çalışmamızın sonuçlarına göre supraaortik dallarda tıkayıcı aterosklerotik damar hastalığı gelişmesi durumunda endovasküler girişim güvenle uygulanabilir. Bu tedavinin mortalitesive morbiditesi oldukça düşüktür. Takiplerinde restenoz gelişen hastalara tekrar girişim güvenle uygulanabilir. Aynı hasta grubunda çoklu lezyon var ise aynı seansta çoklu girişim güvenle uygulanabilen bir tedavi seçeneğidir.

Anahtar Kelimeler:

Supraaortik ark, endovasküler tedavi, tıkanıklık

Simultaneous balloon angioplasty and stent ımplantation in supraaortic multiple stenosis

Purpose: The aim of this study was to evaluate the success and complications of endovascular treatment in supraaortic multiple stenotic lesionsMaterials and Methods: The study was planned as a retrospectively. The records of patients who underwent percutaneous interventional treatment for multiple stenosis in the supraaortic vessels between January 1, 2004 and December 31, 2009 were reviewed. Percutaneous endovascular intervention was decided with doppler ultrasonography, magnetic resonance imaging, computed tomography or digital subtraction angiography provided that more than 50% stenosis was detected in the supraaortic vessels. Patients with at least 2 severe stenosis who underwent multiple interventional procedures in one session were included in the study.Results: A total of 34 patients (mean age 60.4 ± 12.5 years and 6 female (17.4%)) were included in the study. A total of 74 lesions were treated in 34 patients. Stents were used in all procedures. No mortality or serious morbidity was observed during follow-up. The technical success of the procedure was 100%. Restenosis was observed in 4 patients (11.7%) at a mean follow-up of 29.5 ± 18.3 months. Three of these patients were re-treated.Conclusion: According to the results of our study, endovascular intervention can be safely performed in occlusive atherosclerotic vascular disease of the supraaortic branches. Mortality and morbidity of this treatment is very low. In patients with restenosis during follow-up, re-intervention can be performed safely. If multiple lesions are present in the same patient group, multiple interventions are a safe treatment option.

Keywords:

Endovascular treatment, occlusion, supraaortic arch,

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