Subklavian arter hastalığında kobalt krom stentlerin uygulaması

Öz

Amaç: Üst ekstremiteyi etkileyen iskemik problemlerden biri subklavian arter darlığıdır. Son zamanlarda endovasküler tedavi, cerrahi tedaviye alternatif bir tedavi olmuştur. Bu çalışmanın amacı hastalıkla baş etmede yeni bir yol olarak sol subklavian arter hastalığında (LSAH) kobalt krom stentin endovasküler tedavide etkinliğini araştırmaktır.

Gereç ve Yöntemler: Nisan 2011 ile Aralık 2014 yılları arasında LSAH nedeniyle endovasküler tedavi yapılan 30 hasta geriye dönük olarak incelendi. Hastaların vertebrobaziler yetmezlik (16 hasta, %53), sol kol iskemisi (5 hasta, %17) ve anjina (4 hasta, %13,3) semptomları mevcuttu. Tüm hastalarda sol subklavian arter proksimal bölgesi etkilenmişti.

Bulgular: 25 hastada (%72) sol subklavian arter darlığı, 5 hastada (%28) ise tam tıkalı lezyon mevcuttu. Ortalama lezyon uzunluğu 21,60 ± 4,58 mm idi. Ortalama damar çapı 8,7 ± 3,8 mm ve lezyon tipi %40 hastada egzantrikti. Tüm hastalarda kobalt krom balonla genişleyen stent kullanıldı. Teknik başarı %100 idi. Endovasküler tedavi sonrası bir yıllık takipte yeniden daralma izlenmedi.

Sonuçlar: Kobalt krom balonla genişleyen stent avantajlı özellikleri nedeniyle LSAH da başarılı sonuçlara sahiptir.

Anahtar Kelimeler

• Subklavian arter,tıkayıcı arter hastalığı,endovasküler,kobalt krom,stent

Application of cobalt chromium stents in the subclavian arterial disease

Öz

Aim: One of the ischemic problems influencing the upper extremities is subclavian artery stenosis. Recently, endovascular management has become a therapy alternative to surgical treatment. This study aims to investigate the effectiveness of the endovascular therapy with cobalt chromium stent in the left subclavian arterial disease (LSAD) as a novelty.

Material and Methods: 30 patients who underwent endovascular therapy because of LSAD were retrospectively investigated from April 2011 to December 2014. They have symptoms of vertebrobasilar insufficiency (16 patients, 53%), arm ischemia (5 patients, 17 %), and angina (4 patients, 13.3%). All patients had proximal region stenosis or total occlusion in the left subclavian artery.

Results: 25 patients (72%) had left subclavian artery stenosis, whereas five patients (28%) had left subclavian artery total occlusion. The average lesion length was 21.60 ± 4.58 mm. The average vessel diameter was 87 ± 3.8 mm. Eccentric types of lesions were encountered in stenotic cases (n= 12, 40%). Predilatation was performed in 7 patients. Average stent length was 33.1±12.2 mm. Cobalt chromium stent balloon-expandable stents were used for all patients. Technical success in the endovascular treatment was 100%. One year after the endovascular intervention, no seen restenosis were observed.

Conclusion: Due to the advantageous features, cobalt chromium balloon-expandable stents have produced successful results in LSAD.

Anahtar Kelimeler

• Subclavian artery,arterial occlusive disease,endovascular procedure,cobalt chromium,stent

Kaynakça

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