Experience of endovascular treatment of occlusion-stenotic lesions of cerebral arteries
Journal Title: Медичні перспективи - Year 2016, Vol 21, Issue 1
Abstract
Objective — to evaluate the efficacy of endovascular techniques in the treatment of occlusion and stenotic lesions of the brachiocephalic and cerebral arteries, to define the ways of complications prevention. Materials and methods. 594 patients with occlusion and stenotic lesions of the brachiocephalic and cerebral arteries were operated by endovascular methods in endovascular center of Dnipropetrovsk Regional Clinical Hospital named after I.I. Mechnikov. 688 endovascular operations were carried out. Most part of the operations are carotid stenting (423 operations). All of these operations were carried out with the usage of different types of antiembolic protection systems: distal, proximal or their combination. Intracranial segments of cerebral arteries were operated in 43 cases. 169 operations of stenting of vertebral arteries in extracranial segments were performed. Subclavian arteries and brachiocephal truncus were operated in 53 cases. Results. Total removal of stenosis was achieved in 588 cases (98.99%). 509 patients (85.69% of cases) had improvement in neurological status (on a scale NIHHS, Mrs., MoCA). 77 (12.96%) patients had no deterioration of neurological status. Postoperative mortality was 1.01%. Common level of other complications was 4.3 %: cerebral complications - 2.7%. Discussion. The results of the endovascular treatment of occlusion and stenotic lesions of the cerebral arteries show high efficacy and low complication level. The ways of reduction complications level are identified. They are in a differentiated selection of antiembolic protection method, endovascular treatment planning, based on monitoring of changes in the brain hemoperfusion, the emphasis is on the use of the special neurologic deviсes. Conclusions. Endovascular treatment of occlusion and stenotic lesions of the cerebral arteries is effective with a small risk of complications. Risk can be reduced further by the differential choice of antiembolic protection methods, with the help of wide use of special cerebral balloon-catheters and stents for the treatment of stenotic pathology of intracranial arteries, by planning stages of endovascular treatment, based on the clinical data, data of cerebral hemoperfusion in various areas of the brain, and cerebral angiography.
Authors and Affiliations
Yu. Cherednichenko
Keywords
Related Articles
- EP ID EP106841
- DOI -
- Views 81
- Downloads 0
Биостатистический анализ результатов лечения бактериальных абсцессов печени с использованием малоинвазивных методов и открытых хирургических вмешательств
На сьогоднішній день бактеріальні абсцеси залишаються одними з найтяжчих ускладнень у хірургічній гепатології, для лікування яких використовують як традиційні методи лікування, так і малоінвазивні методики. Тому використ...
Порівняння моделей оцінки ризику носійства мутації BRCA1 та BRCA2 у хворих на рак молочної залози
Проведен анализ эффективности использования алгоритма BOADICEA и Манчестерской балльной системы для прогнозирования носительства мутаций BRCA1 и BRCA2 у пациентов с раком молочной железы, проживающих на территории Украин...
Клінічне та «кліпове» мислення на різних етапах навчання за фахом «Загальна практика-сімейна медицина»
Клиническое и «клиповое» мышление на различных этапах обучения по специальности «Общая практика - семейная медицина». Ехалов В.В., Гайдук О.И, Кузьмина А.П., Гайдук Т.А. Проведено анонимное анкетирование - опрос студенто...
Morphologic and immune-histochemic peculiarities of placenta in its dysfunction in anemia of pregnancy
Placental dysfunction occurs in 17-35% of pregnant women. Iron deficiency anemia complicating pregnancy and childbirth affects fetal development. In its turn, pregnancy contributes to the rapid progress of iron deficienc...
Dynamics of parameters of ultrasonic, microbiological and cytological investigations in the treatment of postoperative wound complications using magnesium containing minerals in the elderly patients
57 patients aged over 60 years with various types of wound complications after surgery for abdominal and anterior abdominal wall were treated. Treatment of wound complications included both traditional methods and the us...