Purpose
In Slovenia we have already started theNational Carotid Angioplasty Study. Since the carotid angioplasty and stenting (CAS) is a new procedure, it is essential to establish the clinical outcome before its introduction widely into the clinical practice. Inthe present study the clinical impairement and the efficacy of theCAS in thesymptomatic patients with the severe carotid stenosis (>70%) were evaluated.
Methods and Materials
From February 2001 toOctober 2002 we performed CASinthe 60 patients aged from 51 to 82 years (mean 67 years).41 of them were male and 19 female. All of them were symptomatic (41 TIA, 19 minor stroke) with the severe carotid stenosis (>70%). During the procedure cerebral protection filters: Angioguard, Neurosheild, Filterwirein58 patientsand the Parodi Anti Emboli System (PAES)in 2 cases were used.The patients were evaluatedby a neurologist prior to andafter theCAS, and at follow up visit after1 and3 months.NIH-NINDS stroke scale was used in order...
Results
Technical success (<30% residual stenosis) was achieved in58 of60 cases (96,7%). We have failed in two cases because of the tortuos distal internal artery andof the thrombus in thestenosis. The femoral access was used in majority of cases. Only in one patient theaxillar access was used because of high grade proximal stenosis of the inominate artery. In the same session and approach we dilated also thestenosis of the ipsilateral internal carotid artery under the cerebral protection.NIH-NINDS stroke scale at start was 1,13 while it increased...
Conclusion
We have concluded that clinicalimpairment after CAS remain unchanged. CAS with using the protectiondevicesdoes not produce additional neurologic lesion in chosen patients. CAS seems to be relatively safety procedure.
References
Veith FJ, Amor M, Ohki T, Beebe HG, Bell PRF, Bolia A, Bergeron P, Connors JJ, Diethrich EB, Ferguson RDG, Henry M, Hobson RW, Hopkins LN, Katzen BT, Matthias K, Roubin GS, Theron J, Wholey MH, Yadav SS. Current status of carotid bifurcation angioplasty and stenting based on a consensus of opinion leaders. J Vasc Surg 2001;31:S111-6. Jiri J, Vitek A, Gary SR, Al-Mubareka N, Gishel N, Sriram SI. Carotid Artery Stenting: Technical Considerations. AJNR 2000;21: 1736-43. Albers GW, Hart RG, Lutsep HL, Newell DW,...
Personal Information
Zoran V Miloevic, M.D.Clinical Radiology InstituteUniversity Medical Centre LjubljanaZaloka 7SI-1525 LjubljanaSLOVENIAPhone: +386 1 5223421Fax: +386 1 4331044Email:
[email protected] V Miloevic, M.D. is ECR Research & Education Fund Grant Winner in Year 2002"Carotid angioplasty - efficacy and safety"EAR research grant for a research study from an Eastern European Country funded by EAR, European Association of RadiologyAssoc Prof. Bojana Zvan, MD, PhDHead of Stroke unitUniversity Medical Center, Dept of NeurologyLab. of NeurosonologySI - 1525 Ljubljana, SloveniaPhone: +386 1 522 34 36e-mail:
[email protected]