ABSTRACT
Objective To discuss the surgical characteristics,safety and perioperative management of carotid stent angioplasty (CSA) for the treatment of severe carotid artery stenosis (＞85％).Methods From December 2011 to May 2016,a total of 25 patients with carotid artery stenosis (＞85％) were treated with CSA.According to the stenotic characteristics of the lesion,distal cerebral protection device was employed in performing CSA.During the operation,attention was paid to individualized and detailed surgical management and perioperative management program;the revascularization and the dropping-off of thrombus in cerebral protection device were under close observation,while effort was made to control the occurrence of complications.The patients were followed up for one year to observe the occurrence of ischemic cerebrovascular events.Results The cerebral protection device was successfully deployed after it passed over the severe carotid artery stenosis.After balloon pre-dilation the stent was deployed,and the stent showed satisfactory shape.North America Symptomatic Carotid Endarterectomy Testing (NASCET) showed that the average degree of carotid artery stenosis was decreased from preoperative (91.0±3.1)％ to postoperative (21.0±5.1)％.The protective umbrella was successfully retrieved in all patients,and deciduous tissue fragments were observed in 6 retrieved protective umbrellas.During the perioperative period no severe complications,such as cerebral hemorrhage,cerebral infarction,hyper-perfusion syndrome or death,were observed.All the 25 patients were followed up for one year,and no transient ischemic attack,stroke or death occurred.Conclusion In treating severe carotid artery stenosis with CSA,in order to ensure a successful surgery and patient's safety the following points are very important:in-operative individualized and detailed management,perioperative preventive measures,and use of appropriate cerebral protection device.
ABSTRACT
Objective: To investigate the safety and effectiveness of the Mo. Ma proximal cerebral protection device during carotid artery stenting. Methods: The clinical data of 6 patients with severe internal carotid artery stenosis diagnosed by the Department of Interventional Radiology, Xuanwu Hospital, Capital Medical University from December 2008 to May 2010 were analyzed retrospectively. They were underwent carotid artery stenting and used Mo. Ma cerebral protection device. Neurological and head MRI examinations were performed before and 3 months after the procedure. Results: The clinical symptoms of the 6 patients were improved. The captured small plaques were found in the filter protection device. No patients had dislodgement of emboli. The severe internal carotid artery stenosis were improved significantly after the procedure (residual stenosis rate of <30%). No new ischemic lesions were found in intraoperative and postoperative MRI reexamination. During the use of Mo. Ma cerebral protection device, one patient had the upstream of external carotid blood and the distal cerebral protection device was added. One patient had acute coronary syndrome after surgery and improved after active treatment. Conclusion: In patients with severe carotid artery stenosis who performed stenting, the using of INVATEC Mo. Ma proximal cerebral protection device is relatively safe and effective, but further studies with larger sample is necessary.
ABSTRACT
Objective To explore the safety,efficacy and clinical significance of stenting with cerebral protection devices for carotid artery stenosis.Methods 14 patients with carotid artery stenosis were treated by intra-arterial stents implanted.All of them used cerebral protection of filter devices.Results 18 self-expandable stents were successfully implanted in 14 patients.Of them,stroke ictus caused by microemboli in 2 patients ,and they recovered after treatment for 1~3 d,6 patients had transient bradycardia and hypotension.No cerebral infarction could be seen in all cases during the follow-up period.Conclusion Carotid setenting with cerebral protection devices is an effective and safe method in treating carotid stenosis,and it is helpful to reduce the neurological complication.
ABSTRACT
Objective To investigate the safety and efficacy of carotid angioplasty and stenting(CAS)for the treatment of carotid stenosis with filter cerebral protection devices(CPD).Methods The filter CPD was used in treating carotid artery stenosis by angioplasty and stenting in 19 cases.Cerebral thromboembolic events were noted and the filter devices were observed.All patients were followed-up for short-term.Results The placement of filter CPD and CAS were successfully administered in all patients.Tissue debris could be found in 8 out of 19 with naked eyes in the CPD.There was no death or symptomatic cerebral thromboembolic events during theropy procedure.Short-term follow-up showed excellent results.Conclusion CAS under the filter CPD is a safe and effective method in treating carotid stenosis.The effect of long-term follow-up needs to be further observed and the materials need to be further improved.