Extracranial internal carotid stenting in Phramongkutklao Hospital.

BACKGROUND: Carotid artery occlusive disease is estimated to be the primary cause in 20-30 per cent of all strokes. This report was to demonstrate the safety and efficacy of the treatment of extracranial stenosis by carotid artery stenting. METHOD: From June 1995 to December 2001, there were 13 patients with internal carotid stenosis > or = 60 per cent who were eligible for carotid stenting. RESULTS: Twelve patients were male. The mean age was 68 years old. Fifty-four per cent had neurological symptoms. The percentage of pre stenting stenosis was 86 +/- 8 and the percentage of post stenting stenosis was 18 +/- 15. There were 3 patients who had complications after the procedure (minor stroke = 2, severe bradycardia = 1). One patient died. There were no new or recurrent neurological events during the 6 to 84 month-follow-up. CONCLUSIONS: Carotid stent implantation may be an alternate treatment for extracranial carotid stenosis.

Efficacy and safety of atorvastatin 10 mg every other day in hypercholesterolemia.

OBJECTIVES: The authors sought to evaluate the safety and efficacy of atorvastatin administered every other day in patients with hypercholesterolemia. BACKGROUND: Statins have efficacy in lowering cholesterol and reducing cardiovascular events but their cost is a major disadvantage. Atorvastatin is the most potent statin and has a long half-life. Therefore, atorvastatin given on alternate days may be reasonable and cost effective, particularly in hypercholesterolemia patients. METHOD AND RESULT: Sixty patients with hypercholesterolemia despite diet therapy were enrolled into the study. They received atorvastatin 10 mg every other day before bedtime. Duration of treatment was 8 weeks. A lipid profile was determined as baseline, at 4 weeks and again at 8 weeks. Atorvastatin every other day significantly reduced total cholesterol (TC), triglyceride (TG), and LDL-c versus baseline. The TC, TG, and LDL-c levels were lower by 23 per cent, 8 per cent, and 30 per cent. Increase in HDL-c level was not statistically significant. Three patients had drug side effects. One patient had increased serum transaminase and one patient had increased serum muscle enzyme. The other one had somnolence. CONCLUSIONS: In hypercholesterolemia patients, atorvastatin 10 mg every other day is safe and effective in lowering TC, TG, with LDL-c and a slight increase in HDL-c.