Endovascular Treatment of Carotid Artery Stenosis with Cerebral Protection: 5-year Experience
Authors:
Miroslav Lojík 1
; D. Krajíčková 2; M. Kubíková 2; A. Krajina 1; J. Raupach 1; V. Chovanec 1; J. Schreiberová 3
Authors place of work:
Radiologická klinika LF a FN, Hradec Králové, přednosta: prof. MUDr. P. Eliáš, CSc.
1; Neurologická klinika LF a FN, Hradec Králové, přednosta: doc. MUDr. G. Waberžinek, CSc.
2; Klinika anesteziologie, resuscitace a intenzivní medicíny, LF a FN, Hradec Králové
přednosta: doc. MUDr. V. Černý, Ph. D., FCCM
3
Published in the journal:
Rozhl. Chir., 2007, roč. 86, č. 10, s. 513-520.
Category:
Monothematic special - Original
Summary
Background:
Percutaneous transluminal angioplasty and stenting with cerebral protection is a minimally invasive method for carotid artery stenosis treatment, which may be an alternative to surgical endarterectomy. The aim of our study is to evaluate results of endovascular treatment in patients at high risk of endarterectomy.
Patients and methods:
Between years 2001–2006, 210 carotid artery stenoses in 204 patients were treated in our department. Fourty seven percent of patients suffered from symptomatic stenosis, asymptomatic stenosis was proved in 53% of patients. All asymptomatic patients had stenosis more than 70 % measured according to NASCET, mostly with contralateral carotid artery occlusion.
Results:
The procedure was technically successful in 99% of patients, mortality was 0.49%. Periprocedural embolic complications based on transient ischemic attack were observed in 2.39% of patients, symptoms of minor stroke in 0.47% and symptoms of major stroke in 0.47% of patients. The mortality and disabled morbidity rate in the whole group was 0.96%. One hundred and fifty three patients (73%) were followed up, during this time, 7 patients (3.9%) developed hemodynamically significant restenosis.
Conclusion:
Endovascular carotid artery stenosis treatment with cerebral protection seems to be a safe method of treatment with acceptable short-term results. However, long-term follow – up is needed to get enough data about safety and effectiveness of this method compared to endarterectomy and best medical therapy.
Key words:
carotid artery stenosis – cerebral protection – complications
Zdroje
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