Cigdem DENİZ, Vildan GÜZEL, Gulistan HALAC, Muharrem NASİFOV, Ömer GÖKTEKIN, Talip ASİL

Karotid Arter Darlık Oranı ile Perioperatif Stent Komplikasyonları İlişkisi

Amaç: Biz bu çalışmada karotid arter stentleme (KAS) sonrası oluşabilecek komplikasyonlar, komplikasyonların karotid arter darlık oranları ile ilişkisini incelemeyi amaçladık. Gereç ve Yöntemler: Çalışmaya 205 işlem olmak üzere 195 hasta alındı. KAS sonrası ilk 30 günde ve 1 yılda serebral hiperperfüzyon, inme, ölüm, stent trombozu veya oklüzyonu ve restenoz gibi komplikasyonlar değerlendirildi. Bulgular: 205 KAS işlemde 12 hastada komplikasyon gelişti. 205 KAS işlem sonrası ilk 30 gün için komplikasyon oranı % 4,87 iken, 1. yıl sonunda % 5,85 oranında izlendi. Komplikasyon görülen 12 hastanın 8'inin karotid arterlerinde % 90 ve üzeri darlık mevcuttu. 195 karotid arter hastasının 4’ ünde ölüm gelişti. İlk 30 gün içindeki mortalite oranı % 1,53 iken bir yıllık izlem sürecinde toplam mortalite oranı % 2,05 olarak bulundu. 195 karotid arter hastasının 6’sında iskemik inme saptandı. İlk 30 gün ve bir yıllık takip sonrası iskemik inme oranı % 3,07 olarak saptandı. Stent trombozu ve oklüzyonu oranı 205 KAS işlemde % 4,87 olup, 7’ si ilk 24 saatte, 3’ ü ise ilk 30 gün içinde meydana gelmişti. Restenoz ilk 6 ay sonunda % 0,48 oranında görülürken, bu oran ilk bir yıl sonunda % 0,97 olarak izlendi. Sonuç:KAS işlem için komplikasyon görülme sıklığının bilateral karotid arter darlığı olan vakalardan çok; darlık oranın yüksek (%90 ve üzeri), acil ve semptomatik vakalarla ilişkili olduğu gözlemlenmiştir. Ayrıca çalışmamızda stent trombozu ve oklüzyonu en sık KAS komplikasyonu olarak tespit edilmiştir.

Anahtar Kelimeler:

karotid stent, stent komplikasyonu, karotid arter stenozu, stent trombozu

Relationship of Carotid Artery Stenosis Ratio and Perioperative Stent Complications

Objective: This study aimed to examine complications that may occur after carotid artery stenting (CAS) and their relationships with carotid artery stenosis rate. Materials and Methods: Complications, such as cerebral hyperperfusion, stroke, death, stent thrombosis or occlusion and restenosis, were evaluated on the 30th day after CAS and at the end of the first year. Results: Of the 205 CAS procedures, complications developed in 12 patients. The complication rate for the first 30 days after the procedure was 4,87%, and at the end of the first year, it was 5,85%. Of the 12 patients with complications, 8 had carotid stenosis of ≥90%. Death occurred in 4 of 195 patients with carotid artery stenosis. The mortality rate within the first 30 days and during the 1-year follow-up period was 1,53% and 2,05%, respectively. Ischemic stroke occurred in 6 of 195 patients with carotid artery stenosis. After the first 30 days and one year follow-up, ischemic stroke had occurred in 3,07% of patients. Stent thrombosis and occlusion rate was 4,87% in 205 CAS procedures, and 7 of them occurred in the first 24 hours and another 3 occurred within the first 30 days. Restenosis rates were 0,48% and 0,97% at 6 months and the first year, respectively. Conclusion: The complications of CAS have been associated with the urgency of treatment (emergency), symptom presence (symptomatic patients) and high degree of stenosis (≥90%); whereas bilateral stenosis is not associated with complications. In addition, stent thrombosis and occlusion were observed as the most common CAS complication.

Keywords:

carotid stent stent complication, carotid artery stenosis, stent thrombosis, stroke,

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