Angioplastika i stentiranje zajedničke i unutarnje karotidne arterije bez protekcije

master's thesis

• Title (english): Angioplasty and stenting of common and internal carotid artery without protection
• Author: Filip Živić
• Mentor: David Ozretić (mentor)
• Committee member: Marko Radoš (predsjednik povjerenstva)
• Committee member: Gordana Ivanac (član povjerenstva)
• Committee member: David Ozretić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Radiology); Zagreb
• Defense date and country: 2021-07-16, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Radiology

Abstract

Moždani udar (MU) je hitno stanje s lokalnom ishemijom moždanoga parenhima, tj. sa smanjenim dotokom krvi u moždano tkivo i posljedičnom hipoksijom. 30 do 45% svih ishemijskih moždanih udara uzrokovano je aterosklerotskom bolesti velikih arterija u vratu, posebice unutarnje karotidne arterije. Endovaskularni zahvat, kao alternativa kirurškom, je minimalno invazivni zahvat s angioplastikom i postavljanjem potpornice u aterosklerotski suženu krvnu žilu. S ciljem smanjenja tromboembolijskog rizika odnosno povećanja sigurnosti zahvata, koriste se uređaji za distalnu protekciju tj. DPD-i (eng. distal protective device), no još uvijek nije jasno pokazano je li stopa perioperativnih komplikacija niža u zahvatima u kojima je korišten distalni protektivni uređaj. Na uzorku ispitanika koji su bili endovaskularno liječeni zbog stenoze karotidne arterije u KBC Zagreb, analizirali smo demografska i epidemiološka obilježja pacijenata i njihove postoperacijske ishode kako bismo utvrdili postoji li povećan rizik komplikacija ako se zahvat izvodi bez distalnog protektivnog uređaja. Rezultati su pokazali kako u pacijenata liječenih takvim endovaskularnim zahvatom nema statistički značajne razlike u učestalosti mikroembolijskih lezija u mozga detektiranih MR pregledom u odnosu na zahvat s protekcijom, te kako lezije u obje skupine nisu dovele do pogoršanja neurološkog statusa.

Abstract (english)

Stroke is an emergency caused by an underlying local ischemia in the brain, parenchyma and hypoxia. 30-45% of all ischemic strokes are caused by atherosclerosis plaques developing in large arteries of the neck, namely internal carotid arteries. Endovascular procedure, as an alternative to vascular surgery, is a minimally invasive approach that uses angioplasty and deploys expandable stents into narrowed, atherosclerotic blood vessels. Distal protective devices (DPDs) have been introduced with the intent of reducing the risk of thromboembolism, but their effectiveness in reducing the rate of perioperative complications is yet to be proven. We analyzed demographic and epidemiological attributes, as well as postoperative outcomes in patients that were treated for carotid artery disease by endovascular approach in KBC Zagreb. Then, we assessed if the rate of complications was higher in procedures in which DPDs haven't been used. The results showed neither statistical difference in the prevalence of the microembolic lesions nor decline in the neurological status of patients in who lesions were detected by MRI.

• Keywords: intervencijska neuroradiologija; karotidna angioplastika; stentiranje; distalni protektivni uređaji; moždani udar
• Keywords (english): interventional radiology; carotid angioplasty; carotid stenting; distal protective device; stroke
• Language: croatian
• URN:NBN: urn:nbn:hr:105:617061
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2022-06-07 08:18:58