Akar Bayram N, Bozkurt E, Ayhan H, Gürkaş E, Orhan G, Ak F, Bilen E, Sari C, Akçay M, Durmaz T, Keles T
Cardiology Clinics, Ankara Atatürk Education and Research Hospital, Ankara, Turkey.
Perfusion. 2012 Mar;27(2):146-9. doi: 10.1177/0267659111431759. Epub 2012 Jan 16.
Ischemic cerebrovascular events are the most common reason for patients to be bedridden and the third most common reason for death. Many studies in recent years have demonstrated that carotid artery stenting (CAS) may be an alternative to carotid endarterectomy (CEA). In this study, we aimed to report early outcomes of patients who were treated with CAS in our clinic and discuss practicability, advantages and safety of CAS.
Eighty patients who underwent CAS between December 2009 and May 2011 were eligible. The mean age was 65 years (range, 49 - 89 years). Of the study group, 73.75% were males and 26.25% were female. The percentage of asymptomatic patients was 11.7%, and the remaining patients were symptomatic. A distal embolic protection device (Angioguard®) was used in 22% of the patients whereas, in the other patients (78%), a proximal blockage system (Mo.MA®) was used. Self-expandable hybrid stents were implanted in all patients and post-dilatation was performed after implantation. None of the patients suffered from stroke, myocardial infarction or death due to CAS during their hospital stay. The mean follow-up period was 10 months (range 2 - 18 months) after discharge. None of the patients had died or had a stroke, a transient ischemic attack (TIA), or a myocardial infarction during the follow-up period. Re-stenosis was not observed in the follow-up carotid Doppler ultrasonography; flow rates were within normal limits.
No major complication was observed during the early follow-up period in patients who underwent CAS in our clinic. Only 2 (2.5%) patients showed transient numbness and weakness and these did not lead to morbidity. In the management guide of extracranial carotid and vertebral artery diseases, CAS, in the light of recent studies, is recommended as an alternative to CEA in recommendations for revascularization. One of the important issues emphasized in this guide is the experience of centers. Very low complication rates after CAS suggested that, with suitable patient selection and an experienced team, similar results may be obtained.
缺血性脑血管事件是患者卧床不起的最常见原因，也是第三大常见死因。近年来的许多研究表明，颈动脉支架置入术（CAS）可能是颈动脉内膜切除术（CEA）的一种替代方法。在本研究中，我们旨在报告在我们诊所接受CAS治疗的患者的早期结果，并讨论CAS的实用性、优势和安全性。
2009年12月至2011年5月期间接受CAS的80例患者符合条件。平均年龄为65岁（范围49 - 89岁）。研究组中，73.75%为男性，26.25%为女性。无症状患者的比例为11.7%，其余患者有症状。22%的患者使用了远端栓子保护装置（Angioguard®），而其他患者（78%）使用了近端阻断系统（Mo.MA®）。所有患者均植入自膨式混合支架，并在植入后进行后扩张。住院期间，没有患者因CAS发生中风、心肌梗死或死亡。出院后平均随访期为10个月（范围2 - 18个月）。随访期间，没有患者死亡、中风、短暂性脑缺血发作（TIA）或心肌梗死。随访颈动脉多普勒超声未观察到再狭窄；血流速度在正常范围内。
在我们诊所接受CAS治疗的患者早期随访期间未观察到重大并发症。只有2例（2.5%）患者出现短暂麻木和无力，但未导致发病。在颅外颈动脉和椎动脉疾病管理指南中，根据最近的研究，在血管重建建议中，CAS被推荐为CEA的替代方法。本指南强调的一个重要问题是中心的经验。CAS后极低的并发症发生率表明，通过合适的患者选择和经验丰富的团队，可以获得类似的结果。
