Machnik Roman, Paluszek Piotr, Tekieli Łukasz, Dzierwa Karolina, Maciejewski Damian, Trystuła Mariusz, Brzychczy Andrzej, Banaszkiewicz Krzysztof, Musiał Robert, Pieniążek Piotr
Department of Vascular Surgery and Endovascular Interventions, John Paul II Hospital, Krakow, Poland.
Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, John Paul Hospital, Krakow, Poland.
Postepy Kardiol Interwencyjnej. 2017;13(2):130-134. doi: 10.5114/pwki.2017.68139. Epub 2017 May 30.
Prevention of periprocedural stroke has a crucial role in carotid artery stenting (CAS) procedures.
To assess retrospectively 30-day safety and effectiveness of 41 procedures of internal and common carotid artery stenting using the Roadsaver double nitinol layer micromesh stent in 40 non-consecutive patients with symptomatic or high-risk carotid artery stenosis.
The patients were men ( = 31) and women ( = 9); mean age was 67.8 ±7.9 years. Femoral access was used in 39 cases, whereas radial access was used in 2. Proximal ( = 27) or distal ( = 14) embolic neuroprotection was used.
The Roadsaver stents (nominal diameter 7, 8 or 9 mm, length 25 or 30 mm) were implanted successfully in all cases. One minor stroke occurred after common carotid artery intubation with a guiding catheter (before stent deployment) and one transient postprocedural ischemic attack (TIA) of the ipsilateral cerebral hemisphere was observed. Internal/common carotid artery stenosis severity was evaluated by duplex Doppler. Maximal peak systolic velocity (PSV) before CAS was in the range: 2.0-7.0 m/s, mean: 3.9 ±1.0 m/s, at 24-48 h after stenting mean PSV was 1.1 ±0.4 m/s ( < 0.05), and at 30 days 1.1 ±0.3 m/s ( < 0.05). Maximal end-diastolic velocity (EDV) was 0.85-3.5 m/s, mean 1.4 ±0.5 m/s, at 24-48 h after stenting mean EDV was 0.3 ±0.1 m/s ( < 0.05), and at 30 days 0.4 ±0.1 m/s ( < 0.05). No restenosis or thrombosis was observed. Angiographic stenosis decreased from 82.9 ±9.1% (range: 61-97%) to 19.3 ±7.3% (range: 0-34%) ( < 0.05).
The CAS using the Roadsaver stent seems to be safe and effective. Further studies involving larger patient populations and longer follow-up are needed.
围手术期卒中的预防在颈动脉支架置入术（CAS）中起着至关重要的作用。
回顾性评估40例非连续性有症状或高危颈动脉狭窄患者使用Roadsaver双镍钛诺层微网支架进行41例颈内动脉和颈总动脉支架置入术的30天安全性和有效性。
患者中男性31例，女性9例；平均年龄为67.8±7.9岁。39例采用股动脉入路，2例采用桡动脉入路。27例使用近端或14例使用远端栓塞神经保护装置。
所有病例均成功植入Roadsaver支架（标称直径7、8或9mm，长度25或30mm）。1例在使用引导导管进行颈总动脉插管后（支架置入前）发生轻度卒中，观察到1例同侧脑半球术后短暂性缺血发作（TIA）。通过双功多普勒评估颈内动脉/颈总动脉狭窄程度。CAS术前最大收缩期峰值速度（PSV）范围为：2.0 - 7.0m/s，平均为3.9±1.0m/s，支架置入后24 - 48小时平均PSV为1.1±0.4m/s（P<0.05），30天时为1.1±0.3m/s（P<0.
