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Journal of the Korean Neurological Association 2014;32(2): 59-71.
경동맥스텐트삽입술 시술 전 평가와 시술 전후 관리
하연수, 박희권
원광대학교 의과대학 원광대학교병원 신경과, 인하대학교 의과대학 인하대학교병원 신경과 a
Pre-Procedural Evaluation and Peri-Procedural Management in Carotid Artery Stenting
Yeon Soo Ha
Department of Neurology, Wonkwang University Hospital, Wonkwang University School of Medicine, Iksan, Korea Department of Neurology a , Inha University Hospital, Inha University School of Medicine, Incheon, Korea
Abstract
Carotid-artery stenting (CAS) is as an alternative to surgical endarterectomy for severe carotid-artery stenosis. CAS is advantageous over carotid endarterectomy in that it is less invasive and could shorten the hospital stay. A preprocedural evaluation is necessary to assess the patient’s anatomic status or clinical risk factors to determine whether they are a good candidate for CAS. Proper evaluation and management can reduce CAS-associated complications such as embolism and cerebral hyperperfusion syndrome. The frequent use of statins appears to improve the outcome of CAS. Using the appropriate stent type and a protection device could also reduce the complication rate. Given the changes in cerebral hemodynamics following CAS, adequately controlling the blood pressure in individual patients can enhance the efficacy of this treatment. However, there is currently limited data regarding the preprocedural evaluation and periprocedural management for CAS. The evidence and the clinical status related to the preprocedural evaluation and periprocedural management of CAS are presented herein. Key Words: Carotid-artery stenosis, Stroke, Carotid-artery stenting, Evaluation, Management