Intermediate Clinical Follow Up Results of Carotid Artery Stenting: Single Center Study

Yıl 2013, , 65 - 71, 01.06.2013

Ahmet Göktuğ Ertem Ramazan Akdemir Harun Kılıç Ekrem Yeter

https://doi.org/10.5505/sakaryamj.2013.55265

Öz

ObjectiveCarotid artery stent treatment is developed as an alternative of carotid endarterectomy and it is provided by proving the comparison results of technical success' procedure depending morbidity-mortality and restenoses ratings with carotid endarterectomy by extended researches. We tried to present the mid-term clinic results of stent application by using distal emboli tools which are applied to carotid artery disease patients who are decided to have revascularizationMethods20 carotid artery disease patients who were diagnosed in the survey of Cardiology, Emergency and Neurology policlinics were included to the study in years between 2006-2010. The criteria for inclusion to the study was 60-99 % stenoses of diameter in asymptomatic patients who were assessed angiographically by NASCET method or 70-99 % stenoses of diameter in carotid bifurcation.ResultsAfter reaching every patient by phone, it was determined that; in one patient there was a transient ischemic attack, 48 days after the process (5 %), 3 different patients both had minor bleeding (15 %) and had no need for eritrosit transfusion and in one patient there was acute coronary syndrome /unstabil angina (5 %) but medical treatment was offered. One patient with transient ischemic attack an one patient with minor bleeding after the process; both had one day hospital stay (10 %). ConclusionIn the light of the clinic researches, especially the CREST research, which has the closest parameters to our design and population, we tried to measure the success rates of carotid artery stent treatment of our clinic. We tried to use emboli protecting devices on the patients who were included to the study. At the end of the following process we think that carotid artery stent treatment can be an alternative in the group of high risk surgery patients.

Anahtar Kelimeler

Carotis Artery Disease, Carotid Artery Stenting, Distal Emboli Protection Device, Carotis Endarterectomy

Karotis artere stent yerleştirmenin orta dönem klinik sonuçları.: Tek merkez çalışması

Öz

AmaçKarotis arter stent (KAS) tedavisi KEA'ye alternatif bir tedavi olarak gelişmiş olup bu gelişim teknik başarının prosedüre bağlı morbidite-mortalite ve restenoz oranlarının KEA ile karşılaştırılması ile elde edilen sonuçların büyük, geniş serilere dayanan çalışmalarla ispatlanması ile sağlanmıştır. Bu çalışmada kliniğimize başvuran ve revaskülarizasyon kararı alınan karotis arter hastalığı tanısı almış hastalarda distal emboli cihazları kullanılarak stent uygulamasının orta dönem klinik sonuçlarını sunmaya çalıştık. YöntemlerÇalışmaya 2006- 2010 yılları arasında Kardiyoloji polikliniği, Acil Servis ve Nöroloji kliniğini takiplerinde karotis arter hastalığı tanısı almış 20 hasta dahil edildi. Çalışmaya dahil edilme kriteri NASCET metodu ile angiografik olarak değerlendirilip asemptomatik hastalarda % 60-99 çap darlığı veya semptomatik hastalarda % 70-99 çap darlığı olan karotis bifurkasyon darlığı idi.BulgularHastaların hepsine telefon ile ulaşıldıktan sonra sorgulanmaları sonucunda 1 hastada işlemden 48 gün sonrasında geçici iskemik atak (%5), 3'ünde farklı hastalar olmak üzere minör kanama öyküsü olduğu (%15) ve eritrosit transfüzyon ihtiyacının olmadığı ve 1 hastada ise akut koroner sendrom/ unstabil anjina olduğu (%5) fakat medikal tedavi önerildiği öğrenildi. Geçici iskemik atak olan ve işlem sonrasında minör kanama öyküsü olan bir hasta olmak üzere 2 hastanın 1 günlük hastane yatışlarının olduğu öğrenildi (%10).SonuçKlinik çalışmalar ışığında özellikle bizim çalışma dizayn ve popülasyonumuza en yakın parametrelere sahip CREST çalışması ışığında, kliniğimizde yapılan karotis arter stentleme işlemlerinin başarısını ölçmeye çalıştık. Çalışmaya alınan hastalara emboli koruma cihazlarını kullanmaya çalıştık. Takip dönemi sonucunda cerrahi açısından yüksek riskli hasta grubunda karotis arter stentlemenin iyi bir alternatif olabileceğini düşünüyoruz.

Anahtar Kelimeler

Karotis Arter Hastalığı, Karotis Arter Stentleme, Distal Emboli Koruma Cihazları, Karotis Endarterektomi

Kaynakça

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