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Abstract:

A multicentered study based on retrospective data covered 2012 patients and aimed at ascertaining the eficiency of various methods of treating patients with coronary restenosis after stenting. The average percent of complications after restenosis was about 20% during the period of study (1 1+4 months). The metaregression data analysis showed the positive correlation between the stage of residual stenosis of the stentet segment and the probability of complications. As the residual stenosis decreased at 1%, the frequency of complications diminished at 0,9%. Another factors under analysis did not show any evident influence, although we have registered a tendency towards better outcomes of the recurring operations as the diameter of the vessel increased. The recurring balloon angioplasty in cases of short restenosis and intracoronar radiation in cases of diffused restenotic lesions have proved to be the most effective operations. The indications for implanting the additional stents must be given very carefully, especially in cases of diabetes.

 

References

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Abstract:

Aim: was to estimate efficacy and safety of carotid stenting and carotid endarterectomy Г patients, admitted to center of cardiovascular surgery.

Material and methods: we investigated possibilities of treatment with randomization one-by-one, according to admittance to hospital and use of carotid endarterectomy or stenting. Final decision in each case was made by consilium. For the period 2011-2013, 269 patients were treated including 132 patients who underwent carotid endarterectomy and 137 patients who underwent carotid stenting. The majority of patients had an anamnesis of coronary heart disease or needed coronary revascularization. Symptomatic stenosis was an indication for 19,0 % revascularization in both groups (p = 0.994).

Results: there were no in-hospital deaths registered. Incidence of stroke after carotid endarterectomy was 6(4,5%) and 2(1,5%) after stenting. Transient ischemic attack occurred in 3(2,2 %) patients in the stenting and 1 patient (0,76 %) in endarterectomy groups. Major bleeding was observed in both groups with equal frequency (p = 0,584). Defeat of cranial nerves (7,6 %; p = 0,001) was only observed in the endarterectomy group. Finally both methods of carotid revascularization showed the same level of complications (p = 0,569) besides cranial nerve defeat.

Conclusion: carotid stenting and endarterectomy show similar results in the treatment of patients with atherosclerotic lesions of carotid arteries. Both methods can equally be used in clinics with adequate experience in surgical interventions on the heart and peripheral vessels. The complex assessment of the patient and the lesion by the vascular team is necessary.

 

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