[Stents in the treatment of supraaortic vessel stenosis].
We describe and discuss our experience of more than 500 endovascular procedures for revascularisation of acute or chronic occlusion and stenosis of supraaortic vessels using stents in 171 cases. Whereas endovascular treatment of the innominate, subclavian and vertebral arteries are routinely used in atherosclerotic occlusive lesions, carotid stenting is currently being investigated as an alternative treatment to carotid endarterectomy and seems to offer a less invasive, less traumatic and less cost expensive alternative to achieve the goal to prevent stroke. In a subgroup of high surgical risk patients carotid artery stenting with simultaneous embolic protection of the cerebral blood flow by filter systems was even superior to the endarterectomy-treated patients in a prospective, randomized multi-center study (SAPPHIRE): at 30-day follow up the major event rate for the stented group of 156 patients was 5.8% versus 12.6 for the 151 endarterectomy-treated patients.
Abteilung für Neuroradiologie-DRNN-Departement Radiologie, Neuroradiologie, Nuklearmedizin, Universität Bern, Inselspital. gerhard.schroth@insel.ch
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Schroth
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Remonda
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Dai Do
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Brekenfeld
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Ozdoba
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Mattle
D000792:Angiography; D000800:Angioplasty, Balloon / Q000379:methods; D001027:Aortography; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000628:therapy*; D016122:Brachiocephalic Trunk; D016893:Carotid Stenosis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D002560:Cerebrovascular Circulation; D016894:Endarterectomy, Carotid; D005500:Follow-Up Studies; D006801:Humans; D018810:Magnetic Resonance Angiography; D015337:Multicenter Studies as Topic; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D015607:Stents / Q000009:adverse effects; D020521:Stroke / Q000517:prevention & control; D013348:Subclavian Artery; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014711:Vertebral Artery