单中心多学科管理下颈动脉支架置入术的 6 年结果。
Six-year outcomes of carotid artery stenting performed with multidisciplinary management in a single center.
机构信息
Department of Cardiology, University of Health Sciences, Antalya Training and Research Hospital; Antalya-Turkey.
Department of Neurology, University of Health Sciences, Antalya Training and Research Hospital; Antalya-Turkey.
出版信息
Anatol J Cardiol. 2021 Jun;25(6):385-394. doi: 10.14744/AnatolJCardiol.2020.20420.
OBJECTIVE
This study aimed to evaluate the first 30-day results of clinical, periprocedural asymptomatic cranial embolism, and long-term restenosis of the multidisciplinary conducted and evaluated carotid artery stenting (CAS) procedure in our patient group with real-life data.
METHODS
A total of 610 patients who were subjected to consecutive CAS procedures in our center between December 2010 and February 2019 were clinically and radiologically followed up for a mean duration of 6 years. Of the 610 patients, 274 (45%) were symptomatic for carotid artery stenosis, whereas 336 (55%) were identified as asymptomatic. As embolism protection methods, distal protection, proximal protection, and double (distal + proximal) protection was used in 52%, 43%, and 0.3% of patients, respectively.
RESULTS
The success rate of the CAS procedure was 96%. Procedure-related death was reported in 4 (0.6%) patients who successfully underwent the CAS procedure. Moreover, acute carotid artery stent thrombosis, hyperperfusion syndrome, periprocedural major stroke, and periprocedural minor stroke was observed in 4 (0.6%), 2 (0.3%), 2 (0.3%), and 12 (1.9%) patients, respectively. The total clinical complication rates during the first 30 periprocedural days were 1.6% (10 patients) and 3.1% (19 patients) in the asymptomatic and symptomatic groups, respectively. On cranial magnetic resonance imaging performed, asymptomatic ipsilateral cranial microembolism, asymptomatic contralateral cranial microembolism, and bilateral asymptomatic cranial microembolism was detected in 61 (11.6%), 20 (3.8%), 23 (4.4%) patients, respectively. Asymptomatic restenosis was observed in 24 (3.9%) patients.
CONCLUSION
The CAS procedure is a reliable treatment option applicable with acceptable complication and success rates as outlined in the guidelines, when performed following a multidisciplinary evaluation, in the treatment of symptomatic and asymptomatic carotid artery stenosis, including high-risk patient groups.
目的
本研究旨在评估我们的患者群体中多学科进行和评估的颈动脉支架置入术（CAS）的 30 天内临床、围手术期无症状性颅外栓塞和长期再狭窄的初步结果，使用真实数据。
方法
2010 年 12 月至 2019 年 2 月期间，我们中心对 610 例连续接受 CAS 治疗的患者进行了临床和影像学随访，平均随访时间为 6 年。610 例患者中，274 例（45%）为颈动脉狭窄症状性，336 例（55%）为无症状性。在栓塞保护方法中，分别有 52%、43%和 0.3%的患者使用远端保护、近端保护和双（远端+近端）保护。
结果
CAS 手术成功率为 96%。4 例（0.6%）成功接受 CAS 治疗的患者报告了手术相关死亡。此外，4 例（0.6%）患者出现颈动脉支架内急性血栓形成、过度灌注综合征、围手术期大卒中和围手术期小卒中，2 例（0.3%）、2 例（0.3%）和 12 例（1.9%）患者分别出现上述情况。无症状和有症状组在 30 天内的总临床并发症发生率分别为 1.6%（10 例）和 3.1%（19 例）。在进行颅磁共振成像检查时，分别在 61 例（11.6%）、20 例（3.8%）和 23 例（4.4%）患者中发现无症状同侧颅微栓塞、无症状对侧颅微栓塞和双侧无症状颅微栓塞。24 例（3.9%）患者出现无症状性再狭窄。
结论
当按照多学科评估进行治疗时，CAS 手术是一种可靠的治疗选择，具有指南规定的可接受的并发症和成功率，适用于治疗有症状和无症状颈动脉狭窄，包括高危患者群体。
Zotero 插件