Carotid Artery Stenting: Retrospective Evaluation of Experience of an Invasive Tertiary Center

Faruk ERTAŞ, Mehmet Çevik, Mehmet Aluçlu, Halit Acet, Hasan Özdemir, Oğuz Karahan, Nihat Polat, Gülsenem Aktaş

Özet

Objective: Carotid artery stenting (CAS) is being applied more frequently as an alternative mode of treatment to carotid endarterectomy. We aimed to present the short-term clinical outcomes of the patients admitted to our clinic with a diagnosis of carotid artery disease and revascularized by CAS.Methods: The study was retrospective and a single-centered study. Between June 2013-January 2016 the patients with an indication for carotid artery intervention and accepted CAS procedure were included in the study. Clinical characteristics and procedural data of the patients were obtained by scanning patient files. After discharge, hospital records were scanned and patients were called to learn whether or not patients were alive and that they have suffered a recent stroke.Results: We included 82 patients that meet the inclusion criteria in the study. 59% of patients were male with a mean age of 68±9 years. 56% of patients were symptomatic. In all patients, stents were used. 85% of patients distal embolic protection devices and 15% MOMA were used. 64 right, 18 left, and two bilateral carotid arteries were stented with a total of 82 patient of 84 successful CAS. Due to residual stenosis a second stent was implanted only in one patient. One patient experienced a partial muscle weakening in upper extremity due to an air embolism and 2 patients received opac material which recovered spontaneously in 24 hours.Conclusion: CAS is being successfully applied with a very low risk of complications in experienced centers. Short-term clinical results of CAS are quite satisfactory.Key words: stroke, carotid artery stenosis, carotid artery stenting, clinical outcomes

Abstract

Objective: While there are suggestions for oral hydration times after general anesthesia, there is no published study with regard to sedation. The aim of this prospective study was to determine a safe time for oral intake after pediatric sedation and its association with nausea and vomiting after discharge.Methods: A total of 180 children (aged 1 month to 13 years) sedated for magnetic resonance imaging were randomly assigned into three groups. All patients fasted for 6 hours and were allowed to take clear fluids until 2 hours before sedation with thiopental (3 mg/kg). After the patients were transported to the recovery room, we allowed the patients to drink as much clear fluids as they wanted prior to discharge in group I, 1 hour after the patients met the discharge criteria for group II, and 2 hours after the patients met the discharge criteria for group III. All patients were assessed for vomiting in the recovery room until 1 hour after their first oral hydration. The parents were then telephoned the next day and questioned regarding nausea/vomiting and any unanticipated hospital admission.Results: There were no statistically significant intergroup differences with respect to age, sex, weight, or the ASA status. There was no nausea and vomiting in either the recovery or post discharge period in any group. In the telephone questionnaire, no hospital admissions were reported.Conclusion: Oral hydration just before discharge is safe, and fasting children after discharge for a period of time is unnecessary for patients sedated with thiopental.Key words: Sedation, oral intake, postoperative nausea and vomiting

Anahtar kelimeler: İnme, karotis arter darlığı, karotis arter stentleme, klinik sonuç