Interventional radiologist Dr. Gianluca Piccoli and colleagues from the Santa Maria della Misericordia Hospital in Udine performed angioplasty and
stenting on 180 patients with carotid artery disease.
Their results, presented on Wednesday, showed that the technique was as effective as surgery, with comparable rates of neurologic complications and a
similarly low rate of restenosis.
The risks associated with carotid surgery prompted the team to use the stenting technique. Because most surgeons clamp the carotid artery to prevent
bleeding, the flow of blood to the brain is interrupted, increasing the risk of brain injury. Some surgeons use a temporary external shunt to prevent
this problem. The interventional procedure involves less stress for the patient and generally reduces the hospital stay from three or four nights to
one night.
In the three-year study, one patient had a minor stroke three days after treatment, and two deaths (1.2%) and one major stroke (0.6%) occurred. The
global complication rate was four cases (2.34%), three of them neurologic cases (1.75%). The restenosis rate was 4%, using a cutoff of 50% of
stenosis.
Prior to treatment, 60% of patients had neurologic symptoms, 41.3% had had a previous stroke, 34.8% had had a previous transient ischemic attack, and
23.9% had complained of symptoms like dizziness.
Today these procedures are largely used for the heart, but I think that in the future they will be used for every artery and every part of the
body,
Percutaneous transluminal angioplasty and stenting for carotid artery stenosis
A substantive amendment to this systematic review was last made on 23 November 2003. Cochrane reviews are regularly checked and updated if necessary.
Background: Carotid artery stenosis may be treated endovascularly by percutaneous transluminal balloon angioplasty with or without stent insertion or
by primary stenting. Endovascular treatment may be a useful alternative to carotid endarterectomy (CEA), particularly for lesions not suitable for
surgery.
www.cochrane.org...
Vascular diseases are on the rise due to unhealthy eating habbits,in the U.S.alone it's estimated that by 2020 the total number of people suffering
from some sort of vascular disease relating also to large numbers of 'overwieght' people will be around 45%...which in turn will cost the NHS
millions to threat...