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FASCICOLI E ARTICOLI   I PIÙ LETTI   eTOC

ULTIMO FASCICOLOTHE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica

Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,632

Periodicità: Bimestrale

ISSN 0021-9509

Online ISSN 1827-191X

 

The Journal of Cardiovascular Surgery 2003 Giugno;44(3):331-9

THE MULTIFOCAL ATHEROSCLEROTIC PATIENT
DIAGNOSIS AND MANAGEMENT IN 2003 

 II. ENDOVASCULAR PROCEDURES. SHORT AND LONG-TERMS RESULTS

Current status in cervical carotid artery stent placement

Wholey M. H. 1, Wholey M. 2

1 Department of Cardiovascular and Interventional Radiology University of Texas Health Science Center at San Antonio, San Antonio, TX, ­USA
2 Pittsburgh Vascular Institute Shadyside Hospital, ­UPMC, Pittsburgh, PA, ­USA

Aim of ­this ­paper is to pro­vide back­ground infor­ma­tion ­and ­the lat­est devel­op­ments ­and stud­ies per­tain­ing to carot­id ­artery ­stent place­ment in ­the treat­ment of carot­id ­artery occlu­sive dis­ease. A ­review of cur­rent lit­er­a­ture com­bined ­with per­son­al expe­ri­ence in ­the ­field of carot­id stent­ing is present­ed. Endovas­cu­lar ­stent place­ment ­for carot­id ­artery occlu­sive dis­ease is evolv­ing ­from ­its ­initial con­tro­ver­sial posi­tion to ­that of an alter­­na­tive treat­ment of extra­cra­ni­al carot­id ­artery dis­ease. The ­high tech­ni­cal suc­cess (98-99%) as ­well as ­the rel­a­tive­ly ­few com­pli­ca­tions ­makes carot­id stent­ing a sub­sti­tute ­for carot­id endar­te­rec­to­my ­for symp­to­mat­ic ­patients ­and espe­cial­ly ­those ­with ­high med­i­cal comor­bid­ities. With ­the ­advent of dis­tal embol­ic pro­tec­tion, ­the com­pli­ca­tion ­rates ­for carot­id stent­ing ­have ­decreased by approx­i­mate­ly 50% to 2-4% ­for ­most ­major cen­ters. Hence, ­with ­improved tech­nol­o­gy, carot­id stent­ing is becom­ing an ­option ­for asymp­to­mat­ic ­patients, espe­cial­ly ­those ­with ­high sur­gi­cal ­risk. Early ­results ­for pa-ten­cy ­and neu­ro­log­i­cal fol­low-up ­have ­also ­been encour­ag­ing. When we ­first ­began per­form­ing carot­id stent­ing in 1995, we ­used a mix­ture of periph­er­al ­and cor­o­nary tech­niques. As ­stent ­design, ­guide cath­e­ters ­and cere­bral pro­tec­tion devic­es ­have ­become ded­i­cat­ed ­and sophis­ti­cat­ed, ­the tech­ni­cal suc­cess, paten­cy ­and com­pli­ca­tion ­rates ­have ­improved. Carotid stent­ing ­will ­increase in appli­ca­tion in ­the ­future espe­cial­ly ­among ­high sur­gi­cal-­risk ­patients ­with symp­to­mat­ic ­and asymp­to­mat­ic carot­id occlu­sive dis­ease.

lingua: Inglese


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