Khripun A V, Malevannyĭ M V, Kulikovskikh Ia V
Angiol Sosud Khir. 2014;20(4):175-81.
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.
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.
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%.
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.
分析在术后即刻（住院期间）使用近端脑保护系统对颈内动脉（ICA）进行支架置入术的结果。
我们分析了2010年至2013年期间在罗斯托夫地区临床医院区域血管中心连续对283例患者的颈段ICA进行的330例使用近端脑保护MoMa Ultra系统的支架置入术的结果。其中，209例（73.9%）为男性。患者的平均年龄为67.4±9.7岁。共有194例（68.6%）患者有ICA的症状性病变。11例（3.9%）出现急性缺血性卒中的患者在神经功能缺损发作后6小时内进行了急诊ICA支架置入术。5.2%的病例进行了ICA慢性闭塞的再通和支架置入术。通过支架置入术的技术成功率、是否出现新发神经症状、急性冠状动脉事件以及住院期间的致死率来评估血管内介入治疗的结果。
干预的技术成功率为100%。干预后，仅2例（0.6%）患者发生轻度缺血性卒中，住院期间神经症状完全消退。3例（0.9%）患者在低血压背景下发生急性冠状动脉综合征，通过对症状相关冠状动脉进行支架置入术迅速缓解。住院期间的综合指标“卒中、梗死、死亡”为0.6%。
使用近端脑保护系统进行ICA支架置入术的特点是术后即刻卒中、梗死和死亡的发生率较低。所有有ICA动脉粥样硬化病变的患者都应接受冠状动脉造影。在临床实践中使用近端保护系统能够成功地对颈动脉进行全谱血管内介入治疗。
