Angiologiia i sosudistaia khirurgiia = Angiology and vascular surgery · 2014
[Results of scanning of internal carotid arteries using the system of proximal cerebral protection in the immediate postoperative period].
СтатьяНазвание и аннотация: Перевод в очереди
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Khripun A V, Malevannyĭ M V, Kulikovskikh Ia V
Аннотация
AIM: to analyse the outcomes of stenting of internal carotid arteries (ICA) using the system of proximal cerebral protection in the immediate (in-hospital) postoperative period.
MATERIAL AND METHODS: we analysed the outcomes of a total of 330 stenting procedures on the cervical segment of the ICA using the proximal cerebral protection MoMa Ultra system in the immediate postoperative period, which were consecutively performed at the Regional Vascular Centre of the Rostov Regional Clinical Hospital over 2010-2013 in a total of 283 patients. Of these, 209 (73.9%) were men. The patients' mean age amounted to 67.4 ± 9.7 years. A total of 194 (68.6%) patients had symptomatic lesions of the ICA. Emergency ICA stenting within 6 hours from the moment of the onset of neurological deficit was performed in eleven (3.9%) patients presenting with acute ischaemic stroke. Recanalization and stenting of ICA chronic occlusion was performed in 5.2% of cases. The outcomes of endovascular interventions were assessed by the technical success of the stenting procedure, presence or absence of new-onset neurological symptomatology, acute coronary events, and lethal outcomes during hospital stay.
RESULTS: technical success of the intervention amounted to 100%. Resulting from intervention, only two (0.6%) patients endured minor ischaemic stroke with complete regression of neurological symptomatology during the hospital stay. Three (0.9%) patients on the background of hypotension developed acute coronary syndrome rapidly relieved by stenting of the symptom-dependent coronary arteries. The composite index "stroke, infarction, death" over the hospital stay amounted to 0.6%.
CONCLUSION: ICA stenting with the use of proximal cerebral protection systems is characterized by a low incidence rate of stroke, infarction and death in the immediate period. All patients with atherosclerotic lesions of ICA should obligatory undergo coronarography. The use of proximal protection systems in clinical practice makes it possible to successfully perform the whole spectrum of endovascular interventions on carotid arteries.
MATERIAL AND METHODS: we analysed the outcomes of a total of 330 stenting procedures on the cervical segment of the ICA using the proximal cerebral protection MoMa Ultra system in the immediate postoperative period, which were consecutively performed at the Regional Vascular Centre of the Rostov Regional Clinical Hospital over 2010-2013 in a total of 283 patients. Of these, 209 (73.9%) were men. The patients' mean age amounted to 67.4 ± 9.7 years. A total of 194 (68.6%) patients had symptomatic lesions of the ICA. Emergency ICA stenting within 6 hours from the moment of the onset of neurological deficit was performed in eleven (3.9%) patients presenting with acute ischaemic stroke. Recanalization and stenting of ICA chronic occlusion was performed in 5.2% of cases. The outcomes of endovascular interventions were assessed by the technical success of the stenting procedure, presence or absence of new-onset neurological symptomatology, acute coronary events, and lethal outcomes during hospital stay.
RESULTS: technical success of the intervention amounted to 100%. Resulting from intervention, only two (0.6%) patients endured minor ischaemic stroke with complete regression of neurological symptomatology during the hospital stay. Three (0.9%) patients on the background of hypotension developed acute coronary syndrome rapidly relieved by stenting of the symptom-dependent coronary arteries. The composite index "stroke, infarction, death" over the hospital stay amounted to 0.6%.
CONCLUSION: ICA stenting with the use of proximal cerebral protection systems is characterized by a low incidence rate of stroke, infarction and death in the immediate period. All patients with atherosclerotic lesions of ICA should obligatory undergo coronarography. The use of proximal protection systems in clinical practice makes it possible to successfully perform the whole spectrum of endovascular interventions on carotid arteries.