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학제간연구 과학기술학 뇌인지과학 기술정책 기타 복합학

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논문 기본 정보

자료유형
학술저널
저자정보
Lee, Jong Hyeok (Department of Neurosurgery, Eulji University Hospital, College of Medicine, Eulji University) Sohn, Hee Eon (Department of Neurosurgery, Eulji University Hospital, College of Medicine, Eulji University) Chung, Seung Young (Department of Neurosurgery, Eulji University Hospital, College of Medicine, Eulji University) Park, Moon Sun (Department of Neurosurgery, Eulji University Hospital, College of Medicine, Eulji University) Kim, Seong Min (Department of Neurosurgery, Eulji University Hospital, College of Medicine, Eulji University) Lee, Do Sung (Department of Neurosurgery, Eulji University Hospital, College of Medicine, Eulji University)
저널정보
대한신경외과학회 대한신경외과학회지 대한신경외과학회지 제58권 제4호
발행연도
2015.1
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316 - 320 (5page)

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Objective : The main concern during transfemoral carotid artery stenting (CAS) is preventing cerebral embolus dislodgement. We compared clinical outcomes and intraprocedural embolization rates of CAS using a distal filter protection device or proximal balloon occlusion device. Methods : From January 2011 to March 2015, a series of 58 patients with symptomatic or asymptomatic internal carotid artery stenosis ${\geq}70%$ were treated with CAS with embolic protection device in single center. All patients underwent post-CAS diffusion-weighted magnetic resonance imaging (DW-MRI) to detect new ischemic lesions. We compared clinical outcomes and postprocedural embolization rates. Results : CAS was performed in all 61 patients. Distal filter protection success rate was 96.6% (28/29), whose mean age was 70.9 years, and mean stenosis was 81%. Their preprocedural infarction rate was 39% (11/28). Subsequent DW-MRI revealed 96 new ischemic lesions in 71% (20/28) patients. In contrast, the proximal balloon occlusion device success rate was 93.8% (30/32), whose mean age was 68.8 years and mean stenosis was 86%. Preprocedure infarction rate was 47% (14/30). DW-MRI revealed 45 new ischemic lesions in 57% (17/30) patients. Compared with distal filter protection device, proximal balloon occlusion device resulted in fewer ischemic lesions per patient (p=0.028). In each group, type of stent during CAS had no significant effect on number of periprocedural embolisms. Only 2 neurologic events occurred in the successfully treated patients (one from each group). Conclusion : Transfemoral CAS with proximal balloon occlusion device achieves good results. Compared with distal filter protection, proximal balloon occlusion might be more effective in reducing cerebral embolism during CAS.
#Carotid stenosis #Diffusion magnetic resonance #Embolic protection device #Cerebral infarction

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참고문헌 (20)

참고문헌 신청
Barnett HJM. / 1998 / Final results of the North American Symptomatic Carotid Endarterectomy Trial(nascet) / Stroke 29:286 google schola Biasi GM. / 2004 / Carotid plaque echolucency increases the risk of stroke in carotid stenting : the Imaging in Carotid Angioplasty and Risk of Stroke(ICAROS)study / Circulation 110:756~762 google schola Bijuklic K. / 2012 / The PROFI study(PrevenTable tion of Cerebral Embolization by Proximal Balloon Occlusion Compared to Filter Protection During Carotid Artery Stenting) : a prospective randomized trial / J Am Coll Cardiol 59:1383~1389 google schola Cohen SA. / 2005 / Effectiveness of embolic protection in capturing debris and reducing 30-day stroke rates during carotid stenting / Circulation 112:U476 google schola El-Koussy M. / 2007 / Periprocedural embolic events related to carotid artery stenting detected by diffusion-weighted MRI : comparison between proximal and distal embolus protection devices / J Endovasc Ther 14:293~303 google schola

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