Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/S1677-54492006000400004
Jornal Vascular Brasileiro
Original Article

Estudo prospectivo comparativo entre a endarterectomia e a angioplastia com stent e proteção cerebral no tratamento das lesões ateroscleróticas carotídeas: resultados em 30 dias

Prospective and comparative study between endarterectomy and stent angioplasty with cerebral protection in carotid atherosclerotic lesions: 30-day results

Eugênio Carlos de Almeida Tinoco; Luis Felipe da Silva; Bruno Baião Luquini; Rafael Campanha; Marcelo Nascimento; Luciana Horta

http://dx.doi.org/10.1590/S1677-54492006000400004 J Vasc Bras, vol.5, n4, p.257-262, 2006
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Resumo

OBJETIVO: Analisar comparativamente os resultados, em 30 dias, entre a endarterectomia e a angioplastia com stent auto-expansível e filtro de proteção cerebral, avaliando a incidência de acidente vascular cerebral e óbito, bem como o tempo de permanência hospitalar no tratamento das lesões ateroscleróticas da bifurcação carotídea. MÉTODO: Estudo prospectivo, em que foram tratados 80 pacientes, sintomáticos e assintomáticos, com lesões estenóticas maiores que 60 e 70%, respectivamente, da bifurcação carotídea. Os pacientes foram divididos em dois grupos de 40 pacientes, que foram avaliados quanto a sexo, idade, comorbidades associadas e tabagismo. RESULTADOS: A taxa de acidente vascular cerebral e óbito foi de 5,0% em ambas as técnicas. Ocorreu um caso (2,5%) de ataque isquêmico transitório no grupo endovascular e nenhum na endarterectomia. No que se refere ao tempo de internação, o tratamento endovascular apresentou menor tempo em relação à endarterectomia, sendo estatisticamente significativo (P < 0,002). CONCLUSÕES: Nesta série apresentada, a incidência de acidente vascular cerebral e óbito em 30 dias foi de 5% nas duas técnicas utilizadas. Em relação ao tempo de internação, houve um menor tempo de permanência hospitalar a favor da técnica endovascular, com significância estatística (P < 0,002).

Palavras-chave

Carótida, endarterectomia, angioplastia

Abstract

OBJECTIVE: To comparatively analyze the 30-day results between endarterectomy and angioplasty using self-expandable stent and filter protection in the treatment of carotid bifurcation atherosclerotic lesions. The primary endpoint was to analyze stroke and death rate, as well hospitalization time. METHODS: Comparative and prospective study in 80 symptomatic and asymptomatic patients, with carotid bifurcation stenotic lesions greater than 60 and 70%, respectively. The patients were divided into two groups of 40 and assessed according to gender, age, associated comorbid conditions and smoking. RESULTS: The stroke and death rate was 5.0% for both techniques. There was only one case of transient ischemic attack (2.5%) in the endovascular group. Regarding hospitalization time, it was significantly lower in favor of the endovascular technique, with statistical significance (P < 0.002). CONCLUSIONS: This study demonstrated a 5.0% incidence of stroke and death in 30 days considering both techniques. However, the endovascular group presented a statistically significant shorter hospitalization time than the endarterectomy group (P < 0.002).

Keywords

Carotid, endarterectomy, angioplasty

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