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Slovenian carotid angioplasty study: initial experience
Miloševič, Zoran ...
Carotid endarterectomy (CEA) is widely used in the management of high grade carotid stenosis. It is a surgical procedure requiring general anaesthesia andis suitable only for lesions located at or ...close to the carotid bifurcation. It has complications, including stroke, death, cranial nerve palsies, wound haematoma and cardiac complications.The risk of complications is increased in patients with recurrent carotid artery stenosis following CEA,in subjects andergoing radiotherapy to the neck, and in the presence of cardiopulmonary disease. The drawbacks of CEA have led physicians to search for alternative treatment options. Carotid angioplasty and stenting (CAS) is less invasive than CEA. The method is particularly suitable for the treatment of recurrent stenosis after previous CEA and distal internal artery stenosis, which is inaccessible for CEA. CAS does not cause cranial nerve palsies. Moreover, it does not require general anaesthesia and carries a lower morbidity and mortality in patients with severe cardiopulmonary disease. The complications of CAS include stroke due to distal embolization of a plaque or thrombus dislodged during the procedure, abrupt vessel occlusion due to thrombosis, dissection or vasospasm, and restenosis due to intimal hyperplasia. CAS is a relatively new procedure and it is essential to establish its efficacy and safety before it is introduced widely into clinicalpractice. Throughout the world, several teams are actively engaged inresearch in order to determine the indications, the suitable techniques, theadjunct treatments, and the follow-up conditions. In Slovenia, we have alsostarted with carotid angioplasty by the study: Slovenian Carotid Angioplasty Study (SCAS). According to our initial experience on 17 patients CAS could gain more importance in stroke prevention with proper selection of patients and improved cerebral protection during procedure.
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