کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
5874094 1144665 2014 6 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Treatment Strategy for Bilateral Carotid Stenosis: 2 Cases of Carotid Endarterectomy for the Symptomatic Side Followed by Carotid Stenting
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی مغز و اعصاب بالینی
پیش نمایش صفحه اول مقاله
Treatment Strategy for Bilateral Carotid Stenosis: 2 Cases of Carotid Endarterectomy for the Symptomatic Side Followed by Carotid Stenting
چکیده انگلیسی
Since the introduction of carotid stenting (CAS), a combined treatment for bilateral lesions using carotid endarterectomy (CEA) and CAS has been developed. However, there has been only 1 report about CEA then CAS. Herein we describe 2 patients with bilateral severe carotid stenosis who were treated by CEA for the symptomatic side and CAS for the contralateral asymptomatic side. A 71-year-old man underwent CEA for the symptomatic side. Although the patient suffered hyperperfusion syndrome after CEA, he recovered fully after 3 weeks of rehabilitation. Two months later, CAS was performed for the asymptomatic side, and he was discharged with no deficit. A 67-year-old man underwent CEA for the symptomatic side. The patient developed no postoperative neurologic deficits except for hoarseness. Four weeks later, CAS was performed for the contralateral asymptomatic side. After the procedure, however, severe hypotension occurred, and treatment by continuous injection of catecholamine was necessary to maintain systematic blood pressure. The patient was ultimately discharged with no deficit. The combined therapy of CAS for the asymptomatic side and then CEA for the symptomatic side has been recommended by several authors. However, one of the problems of this strategy is the higher incidence of postprocedural hemodynamic complications, and hypotension after CAS may be dangerous for the symptomatic hemisphere. We suggest a combined therapy using CEA for the symptomatic side and then CAS for the asymptomatic side can be 1 beneficial treatment option for patients with bilateral carotid stenosis without coronary artery disease.
ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of Stroke and Cerebrovascular Diseases - Volume 23, Issue 10, November–December 2014, Pages 2851-2856
نویسندگان
, , , , , , , , , , , , ,