Karotis Artere Stent Yerleştirme İşleminde Tersiyer Merkez Deneyimi ve Kısa Dönem Sonuçlar

Giriş: Karotis arter darlığı olan hastalar inme ve kardiyovasküler ölüm açısından artmış risk altındadır. Bizim bu çalışmadaki amacımız, karotis artere endovasküler girişiminde tersiyer merkez olarak kısa dönem sonuçlarını sunmaktır. Hastalar ve Yöntem: Karotis artere stent yerleştirme (KAS) işlemi uygulanan 220 [169 erkek ve 51 kadın, ortanca yaş 66 (45-83)] hasta çalışmaya dahil edildi. Tüm olgularda distal koruma cihazı kullanıldı. İşlem sonrası bir aylık dönemdeki miyokart infarktüsü (Mİ), inme ve ölümü içeren majör advers olaylar ve işleme bağlı hipotansiyon ve geçici serebral iskemik olaylar değerlendirildi. Bulgular: İki yüz otuz bir karotis arter darlığına stent implantasyonu kararı verildi. On bir hasta (%5) bilateral karotis arter darlığı nedeniyle aşamalı KAS işlemi uygulandı. İşlem başarısı %97 bulundu. Başarılı şekilde KAS işlemi uyguladığımız 1 (%0.4) hastada ölüm gelişti ama hiçbirinde Mİ görülmedi. İki hastada (%0.9) işlemden 24 saat sonra sekelli iskemik serebrovasküler olay gelişti. Toplam 5 (%2.2) hastada işlem sonrası bir aylık dönemde geçici iskemik atak gözlendi. Sekiz (%3.6) hastada işleme bağlı hipotansiyon gelişti. Hiçbir hastada hiperperfüzyon sendromu yaşanmadı. Sonuç: KAS işleminin semptomlu veya semptomsuz hastalarda düşük majör advers serebrovasküler olaylar ve yüksek başarı oranları ile güvenli bir şekilde yapılabileceğini düşünmekteyiz.

Anahtar Kelimeler:

Karotis arter hastalığı, karotis arter stentleme, iskemik inme

Experience at a Tertiary Center and Short-term Results in Carotid Artery Stent Implantation

Introduction: Patients with carotid artery stenosis are at increased risk for stroke and cardiovascular death. Here, we aimed to present the short-term results of carotid artery endovascular procedures performed at our tertiary center. Patients and Methods: Totally, 220 patients [169 males, 51 females; median age, 66 (45-83) years] who underwent carotid artery stent (CAS) placement were included in the study. Post-procedural myocardial infarction (MI); major adverse events, including stroke and death; and procedural hypotension and transient cerebral ischemic events were evaluated in the 1-month period. Results: Totally, 231 carotid stenoses and stents were implanted in all patients. Eleven patients (5%) were treated using staged CAS owing to bilateral carotid artery disease. The technical success rate was 97%. One (0.4%) patient died; however, no MI was observed during successful CAS implantation. Two patients (0.9%) developed ischemic cerebrovascular events 24 hours after the procedure. Totally, 5 patients (2.2%) had a transient ischemic attack in the 1-month period after the procedure. Eight patients (3.6%) developed procedural hypotension. No patient had hyperperfusion syndrome. Conclusion: CAS placement can be safely performed with low major adverse cerebrovascular events and high success rates in symptomatic or asymptomatic patients.

Keywords:

Carotid artery disease, carotid artery stenting, ischemic stroke,

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ISSN: 2149-2972
Yayın Aralığı: Yılda 3 Sayı
Başlangıç: 1990
Yayıncı: Sağlık Bilimleri Üniversitesi, Kartal Koşuyolu Yüksek İhtisas Eğitim ve Araştırma Hastanesi