The choice of the optimal instruments for carotid stenting
Objective – to evaluate the ways of improving of the results of carotid stenting by optimizing the choice of the methods and instruments of the antiembolic protection, and the design of the carotid stent, according to the characteristics of the atherosclerotic plaque and the morphology of the carotid arteries.
Materials and methods. 411 patients with stenotic lesions and occlusion of the extracranial part of internal carotid arteries were operated by endovascular methods in endovascular center of Dnipropetrovsk Regional Clinical Hospital named after I.I. Mechnikov. 479 carotid stenting was performed. All of this operations were carried out with usage of a different types antiembolic protection systems: distal, proximal or their combination and usage of a different types of design of carotid stents. Choice of the method and instruments depended on the characteristics of the atherosclerotic plaque and the morphology of the carotid arteries.
Results. Article shows high efficiency and low level of complications of carotid stenting. Postoperative mortality was 0.73 %. Intraoperative embolic complications were describes in 0.73 %. Reperfusion syndrome was developed in 1.7 % of all cases. Local complications were developed in 1.95 %. Ipsilateral ischemic stroke was developed in 2 cases (0.49 %) during first 30-days period after carotid stenting, and in 4 cases (0.97 %) during 5-years period observation.
Conclusions. Endovascular treatment of stenotic lesions and occlusion of the extracranial part of the carotid arteries are effective and carry a small risk of complications, it can be reduced further by the differential choice of methods and instruments of antiembolic protection and different types of design of carotid stents in accordance with the characteristics of the atherosclerotic plaque and the morphology of the carotid arteries.
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