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Aim: was to estimate the efficiency and safety of stenting of subtotal stenosis of internal carotid artery

Materials and methods: we analyzed data of 31 patients who underwent stenting of subtotal stenosis of internal carotid artery. Middle age was 68,2±6,9 yrs. Research included 23 males (74,2%). 28 patients (90,3%) had ischemic stroke or transient ischemic attack in anamnesis. Asymptomatic patients (9,7%) in the pre-operative stage underwent single-photon emission computed tomography of the brain, which revealed the presence of subtotal stenosis of internal carotid artery complicated with ishemia. Stenting of internal carotid arteries were made with the help of embolic protection devices in all cases (100%), in 90,3% - with additional proximal protection. In 100% - predilatation of critical stenosis zones were performed. Two patients (6,4%) underwent simultaneous stenting of internal carotid artery and vertebral artery in 1 patient (3,2%) - stenting of internal carotid artery and subclavian artery The operative time was equal to the average 32,6±8,7 minutes. The results of endovascular interventions were assessed by the presence / absence of neurological symptoms during hospitalization and in the late postoperative period. Stent patency and the presence / absence of restenosis were determined by ultrasound, selective angiography of the brachiocephalic arteries. Before discharge in asymptomatic patients evaluated cerebral perfusion using single photon emission computed tomography

Results: successful stenting of subtotal stenosis of the internal carotid artery with blood flow restoration (TICI-3) achieved in 100% of cases. According to the single-photon emission computed tomography of the brain, performed before discharge in asymptomatic patients (9.7%) noted improvement in cerebral blood flow. During the observation period, which amounted to 11,6 ± 3,1 months, the new transient ischemic attacks or ischemic strokes were not observed, no deaths. According to the ultrasonic examination - stents in the internal carotid arteries are passable, with no signs of restenosis.

Conclusion: stenting of critical subtotal stenosis of the internal carotid artery is effective and safe. Application of the proximal cerebral protection can reduce the potential risk of embolism during stenting of subtotal stenosis of the internal carotid artery as it provides protection at all stages of the procedure. It is necessary to conduct large randomized studies to confirm the clinical efficacy and determine the indications for this kind of intervention in these group of patients. 



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