Endovascular
Treatment of Carotid Artery Stenosis with Cerebral Protection: 5-year Experience
Lojík M.1, Krajíčková D.2, Kubíková M.2, Krajina A.1, Raupach J.1, Chovanec V.1, Schreiberová J.3
1Radiologická klinika LF a FN, Hradec Králové, přednosta: prof. MUDr. P. Eliáš, CSc. 2Neurologická klinika LF a FN, Hradec Králové, přednosta: doc. MUDr. G. Waberžinek, CSc 3Klinika anesteziologie, resuscitace a intenzivní medicíny, LF a FN, Hradec Králové, přednosta: doc. MUDr. V. Černý, Ph.D., FCCM |
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Summary:
Background: Percutaneous transluminal angioplasty and stenting with cerebral protection is a minimally invasive method for carotid
artery stenosis treatment, which may be an alternative to surgical endarterectomy. The aim of our study is to evaluate results of endovascular
treatment in patients at high risk of endarterectomy.
Patients and methods: Between years 2001–2006, 210 carotid artery stenoses in 204 patients were treated in our department. Fourty
seven percent of patients suffered from symptomatic stenosis, asymptomatic stenosis was proved in 53% of patients. All asymptomatic
patients had stenosis more than 70 % measured according to NASCET, mostly with contralateral carotid artery occlusion.
Results: The procedure was technically successful in 99% of patients, mortality was 0.49%. Periprocedural embolic complications
based on transient ischemic attack were observed in 2.39% of patients, symptoms of minor stroke in 0.47% and symptoms of major stroke
in 0.47% of patients. The mortality and disabled morbidity rate in the whole group was 0.96%. One hundred and fifty three patients
(73%) were followed up, during this time, 7 patients (3.9%) developed hemodynamically significant restenosis.
Conclusion: Endovascular carotid artery stenosis treatment with cerebral protection seems to be a safe method of treatment with
acceptable short-term results. However, long-term follow – up is needed to get enough data about safety and effectiveness of this method
compared to endarterectomy and best medical therapy.
Key words:
carotid artery stenosis – cerebral protection – complications
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