Avtor/Urednik     Miloševič, Zoran; Žvan, Bojana; Zaletel, Marjan; Šurlan, Miloš
Naslov     Carotid angioplasty with cerebral protection
Prevedeni naslov     Karotidna angioplastika z uporabo sredstev za zaščito možganov
Tip     članek
Vir     Radiol Oncol
Vol. in št.     Letnik 36, št. 1
Leto izdaje     2002
Obseg     str. 5-12
ISSN     1318-2099
Jezik     eng
Abstrakt     Background. Carotid endarterectomy (CF.A) is widely used in the management of high-rade carotid stenosis: It is a surgical procedure requiring general anaesthesia and is suitable only for lesions located at or close to the carotid bifurcation. It may develop complications, such as stroke, death, cranial nerve palsies, wound haematoma and cardiac complications. The risk of complications is increased in patients with recurrent carotid artery stenosis following CEA, in subjects undergoing radiotherapy to the neck, and in patients with cardiopulmonary disease. The drawbacks of CEA have led physicians to search for alternative treatment options. Carotid angioplasty and stenting (CAS) is less invasive than CEA. The method is particularly suitable for the treatment of recurrent stenosis after previous CEA and distal internal artery stenosis, which is inaccessible for CEA. CAS does not cause cranial nerve palsies. Moreover, it does not require general anaesthesia and causes lower morbidity and mortality in patients with severe cardiopulmonary disease. The complications of CAS include stroke due to distal immobilisation of a plaque or thrombus dislodged during the procedure, abrupt vessel occlusion due to thrombosis, dissection or vasospasm, and restenosis due to intmal hyperplasia. CAS is a relatively new procedure; therefore, it is essential to establish its efficacy and safety before it is introduced widely into clinical practice. Patients and methods. In Slovenia, we have also started with carotid angioplasty by the study: Slovenian Carotid Angioplasty Study (SCAS). We performed CAS in 17 patients (12 males and 5 females) aged from 69 to 82 years. All patients were symptomatic with stenosis greater than 70 %. 10 patients suffered transient ischemic attacks, 4 patients minor strokes and 3 patients amaurosis fugax. (Abstract truncated at 2000 characters)
Izvleček     Izhodišča. Karotidna endaterektomija (CEA) je kirurško zdravljenje zožitev notranje karotidne arterije, ki se v svetu in pri nas veliko uporablja. Pri CEA je v večffni primerov potrebna splošna anestezija bolnika. Zapleti pri zdravljenju s CEA so možganska kap, paraliza obraznih živcev, hematom v pooperativnem področju in zapleti pri delovanju srca. Tveganje je večje pri bolnikih s ponovnimi zožitvami po CEA, pri bolnikih po radioterapevtskem obsevanju v področju vratu in pri srčnih bolnikih. Karotidna angioplastika s postavitvijo žilne opornice (CAS) je novejša in manj invazivna metoda zdravljenja zožitev notranje karotidne arterije. Metoda je zlasti primerna pri ponovnih zožitvah po CEA in pri distalnih zožitvah notranje karotidne arterije, ki so manj dostopneeza CEA. Pri CAS ni potrebna splošna anestezija bolnika, zato je primernejša za težje srčne bolnike. Zapleti CAS so možganska kap zaradi distalne embolije plaka ali krvnega strdka med posegom, akutna zapora, disekcija ali vazospazem zdravljene arterije in ponovna zožitev zaradi hiperplazije intime arterijske stene. Ker je CAS relativno nova metoda, je potrebno opredeliti učinkovitost in varnost metode, preden se široko uvede v klinično prakso. (Izvleček skrajšan na 2000 znakov)
Deskriptorji     CAROTID ARTERY DISEASES
ANGIOPLASTY
STENTS
CEREBRAL INFARCTION
TREATMENT OUTCOME