Evaluation of Endovascular Treatment Efficacy in Carotid Artery Stenosis

Abstract

Objectives: Carotid artery stenting is an alternative therapeutic approach to carotid endarterectomy in the treatment of atherosclerotic carotid artery stenosis. In this study we evaluated the results of endovascular treatment in our clinic and investigated the restenosis in stents that corresponds to effectiveness of treatment. Material and Method: We evaluated 36 patients with 42 carotid artery stents treated in our clinic between November 2001 and January 2005. We used Doppler ultrasonography in order to search restenosis in the stents. Results: Technical success rate at the endovascular treatment was 100%. Significant restenosis (70%) in totally 42 stents was shown in only 1 patient (2.3%) with increased velocity rates (systolic/diastolic velocities: 175/29 cm/sn). In addition intimal hyperplasia was shown on 2 patients. Conclusion: The results of our endovascular treatment for carotid artery stenosis regarding restenosis ratio of stents and complications of treatment are compatible with literature. ©2007, Fırat Üniversity, Medical Faculty

Keywords

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Karotis Arter Stenozlarında Endovasküler Tedavi Etkinliğinin Değerlendirilmesi

Öz

Giriş: Aterosklerotik karotis arter stenozunda karotis artere stent yerleştirilmesi karotis endarterektomisine alternatif olan bir tedavi yöntemidir. Bu çalışmada endovasküler tedavi uygulanan hastalarda stent açıklığının renkli Doppler Ultrasonografi (RDUS) ile değerlendirilerek tedavinin etkinliğinin araştırılması amaçlanmıştır. Gereç ve Yöntem: Kliniğimizde 2001 Kasım-2005 Ocak arasında emboli koruyucu filtre kullanılarak karotis arter stenozlarına yönelik karotis arter stent tedavisi yapılan 36 olgu RDUS ile değerlendirildi. Otuzaltı olguya takılan toplam 42 stentin RDUS ile değerlendirilmesinde stent içinde restenoz varlığı araştırıldı. Bulgular: Olgulara uygulanan endovasküler tedavide %100 teknik başarı oranı sağlandı. Endovasküler tedavi uygulanan ve toplam 42 stent takılan 36 olgunun takibinde sadece 1 hastada (%2.3) RDUS incelemede stent içerisinde anlamlı restenozu (%70) düşündüren hız artısı saptandı (sistolik hız/diastolik hız: 175/29 cm/sn, ICA sistolik hız/CCA sistolik hız>4). Bunun dışında 2 hastada RDUS incelemesinde anlamlı darlığa yol açmayan intimal hiperplazi izlendi. Sonuç: Karotis stenozlarına yönelik uyguladığımız endovasküler tedavide stentlerin açık kalım oranı ve işleme bağlı komplikasyon oranı literatürde yapılan çalışmalarla uyumludur. Emboli koruyucu filtre kullanımı karotis stenozlarının endovasküler tedavisinde serebrovasküler olay riskini azaltır. ©2007, Fırat Üniversitesi, Tıp Fakültesi

Anahtar Kelimeler

• Karotis, Stenoz, Stent

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