Near Complete Occlusion reconstructed by Carotid Stenting скачать в хорошем качестве

Near Complete Occlusion reconstructed by Carotid Stenting

carotid stenting of near complete occlusion There is ongoing debate over the best course of action for internal carotid artery near-occlusions (NO). In this study, we sought to show the clinical outcomes of carotid artery (NO) stenosis stent implantation in 50 patients who visited our centre and who would later have revascularization. Before receiving a carotid artery stent (CAS), patients had a clinical neurologic examination and underwent carotid artery radiologic imaging. For patients with advanced stenosis, balloon dilatation was used prior to the stent surgery. In the event that there remained any remaining narrowing, post-dilatation was done using a balloon of the proper size. During and after the stent installation surgery, findings such bradycardia, hypotension, reperfusion haemorrhage, individuals who experienced restenosis within a year, and more were noted. Introduction Stroke is one of the leading causes of death and long-term disability. Nearly one-third of people who experience a stroke have carotid artery disease as the underlying cause. Ischemic causes account for the majority of strokes. After receiving medical care for symptomatic carotid artery stenosis, the recurrence rate of strokes is significant. Carotid artery stenosis is typically brought on by atherosclerotic causes, and as the stenosis worsens, so does the risk of stroke. Revascularization is therefore an efficient and secure approach for both primary and secondary stroke prevention in patients who experience stroke or transient ischemic attack as a result of severe carotid artery stenosis as well as in asymptomatic individuals with severe carotid artery stenosis. DISCUSSION An extremely significant contributor to ischemic stroke is carotid artery stenosis. The stroke recurrence rate in patients with symptomatic carotid artery stenosis is about 26% within the first two years of receiving medical care. Annual stroke incidence was estimated to be 2.5% in patients with an asymptomatic carotid artery stenosis (60% receiving medical therapy). Patients with NO instances are the most dangerous carotid stenosis patients. An atherosclerotic plaque that causes hemodynamically significant stenosis in the ICA's bulb is known as NO of the ICA. The distal segments of ICA typically collapse due to residual slow flow through this segment and a decreased post stenotic perfusion pressure, which can be seen on an angiogram as a "string sign." There is ongoing debate concerning the best course of treatment for NO patients. The risk of stroke is minimal with medication treatment, and surgical therapy was not helpful for internal carotid NO, according to assessments done in randomised controlled trials like the North American Symptomatic Carotid Endarterectomy Trial (NASCET) and the European Carotid Surgery Trial (ECST). CONCLUSION The intrinsic process of ICA NO is not well understood, however it may occur more frequently than is currently believed. Making the correct diagnosis in patients who experience new ipsilateral symptoms is crucial, particularly following the diagnosis of ICA stenosis. When carried out by a skilled neuro-interventional team once the diagnosis has been made, CAS appears useful and has a minimal risk of complications. Larger series are needed to determine which patient groups may benefit most because all patients with ICA NO have multiple complex clinical presentations and hemodynamic variables.