Thirty-Day Outcomes of Direct Carotid Artery Stenting With Cerebral Protection in High-Risk Patients
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概要
- 論文の詳細を見る
Background Implantation of a carotid artery stent after predilation is a standard approach in the endovascular treatment of carotid artery stenoses. Stenting without predilation may be an alternative approach in a certain subset of patients. The present prospective, single-center registry was designed to evaluate the feasibility and safety of direct carotid artery stenting (DCAS) in high-risk patients. Methods and Results Symptomatic patients with stenosis >50% and asymptomatic patients with stenosis >70% were eligible for enrolment. Criteria for high-risk patients included: need or history of open heart surgery, history of myocardial infarction, multivessel coronary artery disease, left ventricular dysfunction (ejection fraction ≤40%), severe pulmonary or renal disease, significant contralateral carotid disease, previous endarterectomy, and age ≥80 years. All procedures were performed using a filter protection device. Patients underwent complete clinical examination before and after DCAS and at 30-day follow-up. A total of 83 consecutive patients (45 males, 68±9 years, 33% symptomatic) underwent 100 procedures and 103 stents were deployed successfully. The technical success rate of stenting was 100%. Predilation of carotid stenosis was necessary in 1 (1%) procedure. Carotid-artery stenoses before and after DCAS were 80±9% and 7±9%, respectively. The median fluoroscopic time for DCAS was 7 min. The overall rate of in-hospital major adverse cerebrovascular events (death, stroke, myocardial infarction) was 5% (2 minor strokes, 3 transient attacks). There was 1 (1%) minor stroke within the 30-day follow-up. Conclusion DCAS is feasible and can be performed with an acceptable risk in high-risk patients.
- 社団法人日本循環器学会の論文
- 2007-08-20
著者
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Hajek Petr
Cardio Vascular Center Department Of Cardiology University Hospital Motol
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Veselka Josef
Cardio Vascular Center, Department of Cardiology, University Hospital Motol
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Cerna Daniela
Cardio Vascular Center, Department of Cardiology, University Hospital Motol
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Zimolova Petra
Cardio Vascular Center, Department of Cardiology, University Hospital Motol
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Blasko Peter
Cardio Vascular Center, Department of Cardiology, University Hospital Motol
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Fiedler Jiri
Cardio Vascular Center, Department of Cardiology, University Hospital Motol
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Maly Martin
Cardio Vascular Center, Department of Cardiology, University Hospital Motol
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Zemanek David
Cardio Vascular Center, Department of Cardiology, University Hospital Motol
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Duchonova Radka
CardioVascular Center, Department of Cardiology, University Hospital Motol
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Blasko Petr
Cardio Vascular Center Department Of Cardiology University Hospital Motol
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Maly Martin
Cardio Vascular Center Department Of Cardiology University Hospital Motol
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Fiedler Jiri
Cardio Vascular Center Department Of Cardiology University Hospital Motol
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Cerna Daniela
Cardio Vascular Center Department Of Cardiology University Hospital Motol
-
Veselka Josef
Cardio Vascular Center Department Of Cardiology University Hospital Motol
-
Zemanek David
Cardio Vascular Center Department Of Cardiology University Hospital Motol
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Zimolova Petra
Cardio Vascular Center Department Of Cardiology University Hospital Motol
-
Duchonova Radka
Cardiovascular Center Department Of Cardiology University Hospital Motol
関連論文
- Thirty-Day Outcomes of Direct Carotid Artery Stenting With Cerebral Protection in High-Risk Patients
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