Valentin GOVEDARSKI, Elitsa DIMITROVA, Zornitsa VASSILEVA, Svetoslav DIMITROV, Svetoslav IOVEV

Başarısız karotis arter stentleme sonrasında başarılı cerrahi girişim: Olgu sunumu

Damarlarda lokal daralmaya neden olan çevresel plaklar ile birlikte ciddi karotis darlıklı 56 yaşında kadın hastaya uygun olmayacak bir şekilde karotis arter stentleme yapıldı. Distal emboli koruma cihazı sol internal karotis artere yerleştirildikten sonra, stentleme yapıldı; ancak sert, ciddi düzeyde kalsifiye damar duvarları nedeniyle stent tam olarak yerleştirilemedi. Koruma cihazını tekrar yakalamak için yapılan çeşitli endovasküler girişimler sonuçsuz kaldı ve nihayetinde cihazın kılavuz telinin kırılmasına yol açarak, stent ile birlikte sıkıştı. Stentin ve emboli koruma cihazının karotis tromboendarterektomi ile çıkarılması için acil karotis arteriyotomi yapıldı. Sonuç olarak, koroner arter stentleme için doğru hasta seçimi çok önemlidir.

Failed carotid artery stenting followed by successful surgical intervention: Case report

А 56-year-old female patient with significant carotid stenoses with circumferential plaques, causing localized vascular narrowing, was inappropriately indicated for carotid artery stenting. After placement of a distal embolic protection device in the left internal carotid artery, a stent was inserted; however, it could not be fully deployed due to the rigid, severely calcified vascular walls. The various endovascular attempts to recapture the protection device were futile and, eventually, led to fracture of the guidewire of the device and it remained entrapped together with the stent. Emergency carotid arteriotomy with extirpation of the stent and embolic protection device via carotid thromboendarterectomy was performed. In conclusion, the proper patient selection for carotid artery stenting is of utmost importance.

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