Tekrarlayan karotis arter darlıklarında tedavi stratejimiz
Yıl: 2018 Cilt: 27 Sayı: 2 Sayfa Aralığı: 71 - 77 Metin Dili: Türkçe DOI: 10.9739/tjvs.2018.128 İndeks Tarihi: 25-04-2019
Tekrarlayan karotis arter darlıklarında tedavi stratejimiz
Öz: Amaç: Bu çalışmada karotis arter darlığında izlediğimiz tedavi yöntemlerimiz ve tedavi sonrası tekrarlayan darlıklardaki yaklaşımlarımız sunuldu.Hastalar ve Yöntemler: Ocak 2003 - Haziran 2017 tarihleri arasında karotis arter darlığı nedeni ile müdahale edilen 557 hasta (304 erkek, 253 kadın; ort. yaş 68.2 yıl; dağılım, 54-82 yıl) retrospektif olarak değerlendirildi. Toplam 392 hastaya karotis arter endarterektomisi (KAE) yapılırken, 165 hastaya karotis arter stentleme (KAS) uygulandı. Toplam 392 hastanın 34’üne (%8.6) eversiyon, 188’ine (%47.2) yama ile kapatma ve 170’ine(%43.3) primer kapatma yapıldı. Karotis arter stentleme yapılan 165 hastanın 114’üne (%69) wallstent ve 51’ine (%31) nitinol stent uygulandı. Heriki grupta tekrarlayan karotis arter darlıkları (KAR) ve tedavi yöntemlerinin riskleri incelendi.Bulgular: Toplam 29 hastada (%5.2) KAR saptandı. Bu hastaların sekizi (%4.84) KAS grubundan iken, 21’i (%5.35) KAE grubunda idi. Primerkapatma yapılan hastalarda tekrar müdahale ihtiyacı %9.4 oranında (n=16) iken, bu oran eversiyon yapılan hastalarda %5.88 (n=2) idi. Yama ile kapatılan hasta grubunda tekrar müdahale ihtiyacı ise %1.59 (n=3) idi. Tekrarlayan karotis arter darlığı gelişen 26 hastaya endovasküler girişim yapılırken, iki hastaya tekrar cerrahi girişim yapıldı. Cerrahi girişim yapılan hasta grubunda mortalite izlenmedi. İki hastada da yalnızca sinir hasarı görüldü. Tekrarlayan karotis arter darlığı nedeni ile endovasküler girişim yapılan hasta grubunda da mortalite izlenmedi; ancak bir hastada majör inme gelişti.Sonuç: Karotis arter darlıklarında altın standart tedavi yöntemi KAE’dir. Komorbidite ve mortalitesi yüksek olan hastalar ve KAR’de endovasküler tedavi yöntemleri KAE’ye iyi bir alternatiftir.
Anahtar Kelime: Our treatment strategies of carotid artery restenoses
Öz: Objectives: In this study, we aimed to present our treatment modalities for carotid artery stenosis and approaches for post-treatment restenosis. Patients and methods: Between January 2003 and June 2017, 557 patients (304 males, 253 females; mean age 68.2 years; range, 54 to 82 years) who underwent an intervention due to carotid artery stenosis were retrospectively analyzed. A total of 392 patients underwent carotid artery endarterectomy (CAE), while 165 patients underwent carotid artery stenting (CAS). Of 392 patients, 34 (8.6%) underwent eversion, 188 (47.25) underwent patch closure, and 170 (43.3%) underwent primary closure. Of 165 patients undergoing CAS, 114 (69%) had a wallstent and 51 (31%) had a nitinol stent. Carotid artery restenosis (CAR) and risk of treatment modalities were evaluated in both groups. Results: A total of 29 patients (5.2%) had CAR. Of these patients, eight (4.84%) were from the CAS group, while 21 (5.35%) were from the CEA group. Of the patients undergoing primary closure, the rate of need for reintervention was 9.4% (n=16), this rate was 5.88% (n=2) in the patients undergoing eversion. In the patient group undergoing patch closure, the rate of need for reintervention was 1.59% (n=3). Twenty six patients with CAR underwent endovascular intervention, while two patients underwent surgical intervention. No mortality was observed in patients undergoing surgical intervention. Only nerve damage was seen in both patients. No mortality was observed in patients undergoing endovascular intervention due to CAR; however, one patient had major stroke. Conclusion: Gold standard treatment method in carotid artery stenosis is CAE. Endovascular treatment modalities can be a good alternative to CAE in patients with high comorbidity and high mortality risks and in case of CAR.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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| APA | BEYAZPINAR D, harman a, AKOVALI N, ERSOY Ö, KAYIPMAZ Ç, Gultekin B, AKAY H (2018). Tekrarlayan karotis arter darlıklarında tedavi stratejimiz. , 71 - 77. 10.9739/tjvs.2018.128 |
| Chicago | BEYAZPINAR Deniz Sarp,harman ali,AKOVALI Nükhet,ERSOY Özgür,KAYIPMAZ Çağrı,Gultekin Bahadir,AKAY Hakkı Tankut Tekrarlayan karotis arter darlıklarında tedavi stratejimiz. (2018): 71 - 77. 10.9739/tjvs.2018.128 |
| MLA | BEYAZPINAR Deniz Sarp,harman ali,AKOVALI Nükhet,ERSOY Özgür,KAYIPMAZ Çağrı,Gultekin Bahadir,AKAY Hakkı Tankut Tekrarlayan karotis arter darlıklarında tedavi stratejimiz. , 2018, ss.71 - 77. 10.9739/tjvs.2018.128 |
| AMA | BEYAZPINAR D,harman a,AKOVALI N,ERSOY Ö,KAYIPMAZ Ç,Gultekin B,AKAY H Tekrarlayan karotis arter darlıklarında tedavi stratejimiz. . 2018; 71 - 77. 10.9739/tjvs.2018.128 |
| Vancouver | BEYAZPINAR D,harman a,AKOVALI N,ERSOY Ö,KAYIPMAZ Ç,Gultekin B,AKAY H Tekrarlayan karotis arter darlıklarında tedavi stratejimiz. . 2018; 71 - 77. 10.9739/tjvs.2018.128 |
| IEEE | BEYAZPINAR D,harman a,AKOVALI N,ERSOY Ö,KAYIPMAZ Ç,Gultekin B,AKAY H "Tekrarlayan karotis arter darlıklarında tedavi stratejimiz." , ss.71 - 77, 2018. 10.9739/tjvs.2018.128 |
| ISNAD | BEYAZPINAR, Deniz Sarp vd. "Tekrarlayan karotis arter darlıklarında tedavi stratejimiz". (2018), 71-77. https://doi.org/10.9739/tjvs.2018.128 |
| APA | BEYAZPINAR D, harman a, AKOVALI N, ERSOY Ö, KAYIPMAZ Ç, Gultekin B, AKAY H (2018). Tekrarlayan karotis arter darlıklarında tedavi stratejimiz. Damar Cerrahi Dergisi, 27(2), 71 - 77. 10.9739/tjvs.2018.128 |
| Chicago | BEYAZPINAR Deniz Sarp,harman ali,AKOVALI Nükhet,ERSOY Özgür,KAYIPMAZ Çağrı,Gultekin Bahadir,AKAY Hakkı Tankut Tekrarlayan karotis arter darlıklarında tedavi stratejimiz. Damar Cerrahi Dergisi 27, no.2 (2018): 71 - 77. 10.9739/tjvs.2018.128 |
| MLA | BEYAZPINAR Deniz Sarp,harman ali,AKOVALI Nükhet,ERSOY Özgür,KAYIPMAZ Çağrı,Gultekin Bahadir,AKAY Hakkı Tankut Tekrarlayan karotis arter darlıklarında tedavi stratejimiz. Damar Cerrahi Dergisi, vol.27, no.2, 2018, ss.71 - 77. 10.9739/tjvs.2018.128 |
| AMA | BEYAZPINAR D,harman a,AKOVALI N,ERSOY Ö,KAYIPMAZ Ç,Gultekin B,AKAY H Tekrarlayan karotis arter darlıklarında tedavi stratejimiz. Damar Cerrahi Dergisi. 2018; 27(2): 71 - 77. 10.9739/tjvs.2018.128 |
| Vancouver | BEYAZPINAR D,harman a,AKOVALI N,ERSOY Ö,KAYIPMAZ Ç,Gultekin B,AKAY H Tekrarlayan karotis arter darlıklarında tedavi stratejimiz. Damar Cerrahi Dergisi. 2018; 27(2): 71 - 77. 10.9739/tjvs.2018.128 |
| IEEE | BEYAZPINAR D,harman a,AKOVALI N,ERSOY Ö,KAYIPMAZ Ç,Gultekin B,AKAY H "Tekrarlayan karotis arter darlıklarında tedavi stratejimiz." Damar Cerrahi Dergisi, 27, ss.71 - 77, 2018. 10.9739/tjvs.2018.128 |
| ISNAD | BEYAZPINAR, Deniz Sarp vd. "Tekrarlayan karotis arter darlıklarında tedavi stratejimiz". Damar Cerrahi Dergisi 27/2 (2018), 71-77. https://doi.org/10.9739/tjvs.2018.128 |
