Endovascular treatment of carotid artery stenosis: Early outcomes

Giriş: Karotis arterin oklüzif hastalığında karotis anjiyop-lasti ve stentleme karotid endarterektomiye oranla daha az invazif olan bir alternatiftir. Bu çalışmada ünitemizde 90 hastaya uygulanan karotis arter endovasküler tedavi ve stentleme işlemlerinin erken takip sonuçlarını bildir-meyi amaçladık. Materyal ve Metot: Mart 2004 ve Nisan 2008 tarihleri arasında 90 hastanın 99 lezyonuna endovasküler tedavi ve stentleme uygulanmıştır. Tüm hastalara transfemoral yolla koruma şemsiyesi kullanılarak kendiliğinden geniş-leyen stentler ve gerekli görülürse balon dilatasyon uygulandı. Tüm hastalara 3, 6, 12. aylarda ve daha sonra yılda bir rutin doppler US kontrolü yapıldı. Bulgular: On sekiz hastada komplikasyon gelişti. İşlem sonrası 5 (%5,5) hastada geçici iskemik atak 3 (%3,3) hastada major stroke, 5 (%5,5) hastada miyokard in-farktüsü ve 8 (%8,8) hastada ölüm görüldü. Sonuç: Karotis arter aterosklerotik hastalığında endo-vasküler stentleme işlemi karotid endarterektomiye giderek artan oranda alternatif olarak gösterilmektedir. Özellikle cerrahi için yüksek risk taşıyan hasta grubunda tek seçenek olarak görülmektedir. Son dönemde distal koruma filtrelerinin gelişmesi ile karotis arter stentleme işlemi daha güvenilir ve etkili bir yöntem olmuştur.

Karotis arter stenozlarında endovasküler tedavi ve erken takip sonuçları

Purpose: Carotid artery angioplasty and stenting currently represents a less invasive percutaneous alternative to conventional carotid endarterectomy for the carotid occlusive disease. The aim of this article is to report our experience and early outcomes of carotid stenting in our first 90 consecutive patients. Material and Method: Between March 2004 and April 2008, 90 consecutive patients (74 males, 16 females) with 99 lesions underwent carotid artery angioplasty and stenting at the our interventional radiology unit. All procedures were performed through long transfemoral way with using protection device, self-expandable stents, and balloon dilatation. All patients underwent routine Doppler ultrasound scanning. Results: Within four year of the procedure 18 patients had complications, including cerebrovascular death in one patient, 3 non-fatal major stroke, 5 transient ischemic attacks, 3 stent occlusion, restenosis in five patients. Conclusion: Endovascular stent and treatment of carotid artery atherosclerotic disease is growing as an alternative to vascular surgery, especially for patients that are at high risk for standard carotid endarterectomy. Carotid artery angioplasty and stenting is more feasible and effective when distal protection devices are used.

Kaynakça

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Kaynak Göster

Yeni Tıp Dergisi
  • ISSN: 1300-2317
  • Yayın Aralığı: Yılda 0 Sayı
  • Başlangıç: 2018

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