Simultaneous baloon anjioplasty and stent implantation in supraaortic multiple stenosis

Aim : Endovascular treatment is a less invasive method in supraaortic multiple stenosis and complication rate is lower than the surgical treatment. Endovascular treatment methods takes place of surgical treatment because of the success rate similar to surgical treatment in increasing rates as a result of developments in interventional radiology started in the 1980s. The aim of our study is to evaluate complications associated with the success of the simultaneous endovascular treatment in supraaortic multiple stenotic lesions and to compare these results with the surgical results.Material and Method:In the study 34 patients including 6 women (18%) and 28 men (82%), aged between 19 and 82 (approx. 59.9) were taken, who have many stenosis with supraortic in between 2004-2009 and applied stent or stent and balloon angioplasty treatment. There are total 72 lesions. While Carotid artery stenting is being done, embolic protection filter was used. Patients were followed up with Doppler U.S. after treatment 1 days, 1, 3, 6 and 12 months and a year later. Repeated attempts were made to patients with significant restenosis.51 of them (70.8%) wasResults: Our technical success rate was 100%. There are total 72 lesions and of 51 (70.8%) is at carotid artery, 12 (16.7%) at vertebral artery, and 8 (11.1%) at subclavian artery and 1 (1.4%) at brachiocephalic artery. The most common lesions in 13 patients (38%) had bilateral internal carotid artery lesions. The protection filters were used in 27 patients (79%), embolic material was detected in the fitler at four patients (11.8%). During the procedure bradycardia and hypotension developed in six patients (17.6%), asystole was seen in two patients (5.9%), and arrhythmias was seen in one patient (2.9%). Bradycardia and asystole were treated with atropine. One patient (2.9%) had neck hematoma and was treated with covered stents. The inguinal pseudoaneurysm developed in one patient (2.9%), the patient was operated on. Repeat procedures were performed because of restenosis in three patients.Conclusion: In supraaortic multiple stenosis, the balloon angioplasty and stent implantation made simultaneously is suitable alternative to surgical treatment, and is minimally invasive surgery at least so successful with surgery.Keywords: Endovascular treatment, stenting, balloon angioplasty, cerebral ischemia, arterial stenosis, carotid artery stenting, supraaortic stenosis