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Treatment of Carotid Atherosclerotic Stenosis Using Endovascular Stent Placement

SHI Jin~*,LV Qiang,ZHANG Ying-qian,ZHANG Wei-qing,WANG Jian,PIAO Long-song,SONG Dong-lin.~*Department of Neurology,General Air Force Hospital,Beijing 100036,China  
Objective:To observe the safety and efficacy in high-grade carotid atherosclerotic stenosis using endovascular stent placement.Method:A total of 10 patients with more than 65% stenosis of the proximal internal carotid arteries(ICA) was selected.Seven of them showed the symptoms with transient ischemic attacks(TIAs) and all patients suffered from ischemic strokes.12 self-expanding stents were implanted into narrowing ICA after using brain protection devices.Among the operations,three cases were pre-expanded or post-expanded.Results:The brain protection devices were correctly placed and stenting procedures were technically successful based on angiography in all patients.The mean degree of stenosis was(78.3%±9.4%) before procedure and(12.5%±7.2%) after stenting.There were some procedure-related complications.The heart rates became slow in 8 cases.3 patients were treated with atropine.1 showed transient cerebral hypoperfusion symptom because of bradycardia and hypotension.6 months after operation,there was no TIAs in stenting ICA and other ischemic neurological defects.Following up sonography at months 1,3,6 showed no distortion of stents and re-stenosis.Conclusion: Endovascular self-expanding stenting for ICA stenosis is effective and safe.The long-term results need further investigation.
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