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2011, Number 4

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Rev Med Inst Mex Seguro Soc 2011; 49 (4)

Carotid angioplasty with stent in patients at high risk: intra-hospital results and long-term monitoring

Palacios-Rodríguez JM, Galván-García E, Jiménez-Torres O, Díaz de León-Godoy E, Baena-Santillán E

Language: Spanish
References: 28
Page: 361-366
PDF size: 48.71 Kb.


ABSTRACT

Background: carotid angioplasty with stent (ACS) represents a less invasive alternative to carotid endarterectomy (CEA) for treatment of carotid occlusive disease. Our objective was to analyze the morbidity and mortality 30 days and 6 months after ACS.
Methods: we included 206 patients (231 lesions) with a mean age of 67.46 ± 8.37 years, 40 patients (19.4 %) › 75 years, 66 % were symptomatic, 169 patients (82 %) with history of ischemic heart disease; in 213 lesions (92.2 %) cerebral protection filters were used; clopidogrel 300 mg; aspirin 325, heparin IV 70 UI/kg, temporary pacemaker prophylaxis in ostial lesions of the internal carotid artery were applied.
Results: complications were four procedure-related deaths (1.9 %), five major neurological events (2.16 %) and three minor events (1.3 %); in 104 patients (50.4 % ) a successful coronary angioplasty also was done; the mean follow-up was 26.5 ± 23.2 days; five patients had re-stenosis on Doppler but the angiography documented it only in three patients (1.3 % ), Two of them undergoing uncomplicated PTA. Five patients died over the follow-up, two presented myocardial infarction (MI), two more with a infectious condition and one had not identified the cause.
Conclusions: the ACS is an alternative to surgery in patients with symptomatic carotid disease.


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