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

Yıl 2018, Cilt: 21 Sayı: 2, 93 - 97, 19.08.2018

Sinan Cerşit Müslüm Şahin

Öz

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.

Anahtar Kelimeler

Carotid artery disease, carotid artery stenting, ischemic stroke

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

Öz

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

Kaynakça

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