[논문]The Clinical Outcomes of 75 Consecutive Patients with Cervical Carotid Artery Stenosis Treated by Carotid Artery Stenting

Chung, Joon-Ho; Shin, Yong-Sam; Lim, Yong-Cheol; Park, Sang-Kyu

doi:10.3340/jkns.2009.45.6.350

The Clinical Outcomes of 75 Consecutive Patients with Cervical Carotid Artery Stenosis Treated by Carotid Artery Stenting 원문보기

Journal of Korean Neurosurgical Society = 대한신경외과학회지, v.45 no.6, 2009년, pp.350 - 354

Chung, Joon-Ho (Department of Neurosurgery, Seoul St. Mary's Hospital, The Catholic University of Korea) , Shin, Yong-Sam (Department of Neurosurgery, Seoul St. Mary's Hospital, The Catholic University of Korea) , Lim, Yong-Cheol (Department of Neurosurgery, Ajou University School of Medicine) , Park, Sang-Kyu (Department of Neurosurgery, Incheon St. Mary's Hospital, The Catholic University of Korea)

Abstract ▼ AI-Helper

Objective : The purpose of this study was to analyze the clinical outcome of 75 consecutive patients with cervical carotid artery stenosis and who were treated by carotid artery stenting (CAS) only. Methods : From February 2003 to June 2008, there were 78 stents placed in 75 symptomatic patients (mean age : 67.3 years); 69 patients had carotid stenosis ${\geq}70%$, and 6 patients had asymptomatic stenosis ${\geq}80%$. No carotid endarterectomy (CEA) was performed during the same period. The patients were clinically followed-up for a mean of 20.1 months. Results : The procedures were technically successful in all cases. Three (3.8%) patients had procedure-related complications. During the 30-day postprocedural period, there were no restenosis or major stroke. Minor stroke was noticed in 3 (3.8%) patients and 1 (1.3%) of the 75 patients suddenly expired 2 days after discharge. There were no new neurological symptoms that developed during the clinical follow-up period. The results of our series were not inferior to those the previously published in CAS studies, and in fact they were better. Conclusion : Our results suggest that CAS may be safe and useful for the treatment of cervical carotid artery stenosis when it is used as the first line treatment in those institutions that lack enough experience with CEA.

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제안 방법

The patients received clopidogrel (75 mg/day) and aspirin (100 mg/day) for at least 2 weeks before CAS. The procedures were performed under local anesthesia with strict monitoring of the blood pressure. Among the 78 cases, we used an embolic protection device in the 30 more recent cases.
The purpose of this study was to analyze the clinical outcome of 75 consecutive patients with cervical carotid artery stenosis and who were treated by CAS only.
We retrospectively reviewed the 75 patients for their medical conditions, the initial presentation, the angiographic characteristics of carotid artery stenosis with the stenosis ratio, the technical success rate, the procedure-related complications and the clinical outcomes, as assessed by the 30-day morbidity and mortality. Any new neurologic deficits were scored with using the National Institutes of Health Stroke Scale (NIHSS)¹⁾.

데이터처리

p-value : evaluated by Student t-test. PD : proection device

이론/모형

We retrospectively reviewed the 75 patients for their medical conditions, the initial presentation, the angiographic characteristics of carotid artery stenosis with the stenosis ratio, the technical success rate, the procedure-related complications and the clinical outcomes, as assessed by the 30-day morbidity and mortality. Any new neurologic deficits were scored with using the National Institutes of Health Stroke Scale (NIHSS)¹⁾. Those patients who had a new neurological event lasting longer than 24 hours with an increase in the NIHSS less than 3 and this resolved completely within 30 days were classified as having a minor stroke.

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Lancet SPACE Collaborative Group 368 1239 2006 10.1016/S0140-6736(06)69122-8

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N Engl J Med Yadav 351 1493 2004 10.1056/NEJMoa040127

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DOI : 10.3340/jkns.2009.45.6.350
대한신경외과학회 : 저널
PubMed Central : 저널
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