رسالة جامعية
Ο ρόλος της εγκεφαλικής προστασίας στην ενδαγγειακή αποκατάσταση της καρωτιδικής νόσου ; The role of cerebral embolic protection devices in endovascular management of carotid disease
| العنوان: | Ο ρόλος της εγκεφαλικής προστασίας στην ενδαγγειακή αποκατάσταση της καρωτιδικής νόσου ; The role of cerebral embolic protection devices in endovascular management of carotid disease |
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| المؤلفون: | Giannakopoulos, Triantafyllos, Γιαννακόπουλος, Τριαντάφυλλος |
| بيانات النشر: | National and Kapodistrian University of Athens Εθνικό και Καποδιστριακό Πανεπιστήμιο Αθηνών (ΕΚΠΑ) |
| سنة النشر: | 2020 |
| المجموعة: | National Archive of PhD Theses (National Documentation Centre Greece) |
| مصطلحات موضوعية: | Καρωτιδική αγγειοπλαστική με ενδονάρθηκα, Καρωτιδική νόσος, Καρωτιδικό αθήρωμα, Καρωτιδική πλάκα, Φίλτρο εγκεφαλικής προστασίας, Εγκεφαλική προστασία, Εμβολικό υλικό, Εμβολικά συγκρίματα, Καρωτιδικός ενδονάρθηκας, Ενδαγγειακή αγγειοπλαστική καρωτίδας, Κυτταρολογία υγρής φάσης, ThinPrep, Carotid angioplasty and stenting, CAS, Carotid disease, Carotid atheroma, Carotid plaque, Filter embolic protection devices, Embolic protection device, Embolic debris, Carotid stent, Endovascular carotid angioplasty, Carotid artery stenting, Liquid phase cytology, Ιατρική και Επιστήμες Υγείας, Κλινική Ιατρική, Επιστήμες Υγείας, Medical and Health Sciences, Clinical Medicine, Health Sciences |
| الوصف: | OBJECTIVES: The aim of the study was to investigate debris captured in embolic protection devices (EPD) during carotid angioplasty and stenting (CAS) and its possible correlation with plaque echogenicity and other risk factors. MATERIALS / METHODS: Between June 2010 and March 2011, 51 consecutive patients (11 females, mean age 71.2 +/-7, 10 symptomatic) who underwent 53 CAS procedures were included in this prospective study. Ultrasonographic Gray-Weale plaque type (I-V, echolucent to echogenic) characterization was obtained in all cases. The same type of stent and filter EPD was used. Filters were collected and after macroscopic evaluation, they were examined using the Thin-Prep® liquid based cytology (LBC) technique. Additionally, a systematic review of the literature was performed for publications investigating brain microembolization during CAS from January 2010 to March 2016. RESULTS: Technical success was 100%. Thirty-day stroke and death rates were 1.8% (1/53) and 0% respectively. Visible debris was detected in 8 (15%) filters, whereas liquid based cytology revealed embolic material in 30 filters (56.6%). The presence of emboli into the filter was 2.38-fold increased for every category change from type IV to type I carotid plaques (OR=2.38, 95%CI=1.15-4.93). This remained robust even after adjustment for age, gender and known atherosclerosis risk factors (OR=2.26, 95%CI=1.02-5.02). In multivariate analysis for risk factors hypertension was associated with increased presence of emboli in filter EPD (OR=20.4, 95%CI=1.28-326.1). The time distance from symptom to CAS was inversely correlated with debris quantity in EPD (Spearman rho -0.716; p=0.02). Thirty-eight studies were retrieved and used for brain microembolization phenomenon analysis. CONCLUSIONS: Echolucent plaques, smaller time frame from last symptom and hypertension were associated with increased presence of embolic material. Clinically silent brain microembolization occurs during CAS and requires further investigation. ; ΣΤΟΧΟΣ: Στόχος της μελέτης ... |
| نوع الوثيقة: | doctoral or postdoctoral thesis |
| اللغة: | Greek, Modern (1453-) |
| العلاقة: | http://hdl.handle.net/10442/hedi/48075Test |
| DOI: | 10.12681/eadd/48075 |
| الإتاحة: | https://doi.org/10.12681/eadd/48075Test http://hdl.handle.net/10442/hedi/48075Test |
| رقم الانضمام: | edsbas.77C95621 |
| قاعدة البيانات: | BASE |
| DOI: | 10.12681/eadd/48075 |
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