Técnica de proteção cerebral na angioplastia e "stent" de carótida: um procedimento eficaz contra embolia

Arquivos de Neuro-Psiquiatria 01/2003; DOI: 10.1590/S0004-282X2003000200028
Source: DOAJ

ABSTRACT OBJETIVO: Descrever a técnica de proteção cerebral usada na angioplastia com colocação de "stent" para tratamento de lesões estenóticas da bifurcação carotídea, mostrando sua eficiência em evitar a embolia durante o procedimento. MÉTODOS: QUAREnta e dois pacientes (47 artérias) foram tratados com a técnica de proteção cerebral que consistiu na oclusão temporária da carótida interna acima da estenose, fazendo-se aspiração e injeção de solução de glicose a 5% na carótida interna após a colocação de "stent" e angioplastia, para remover eventuais fragmentos da placa. RESULTADOS: A angioplastia foi eficiente em todos os casos. Não ocorreu embolia nos pacientes deste estudo nos quais se utilizou a técnica de proteção cerebral na sua versão completa. Embolia ocorreu em um paciente, durante pré-dilatação da estenose, antes de se usar a técnica de proteção cerebral. CONCLUSÃO: A técnica de proteção cerebral foi eficiente em evitar a embolia nos procedimentos realizados. Esses dados concordam com os da literatura e o uso desta técnica amplia as indicações da angioplastia carotídea.

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    ABSTRACT: The Carotid and Vertebral Artery Transluminal Angioplasty Study (CAVATAS) is an international multicenter randomized trial, the primary aims of which are: (1) to determine the risks and benefits of carotid and vertebral artery transluminal angioplasty; and (2) to compare these with surgical treatment (carotid endarterectomy) or best medical treatment. Through the end of October 1995, 193 patients have been randomized (90 at our center). In this article, the rationale for the trial, its design and protocol, and the experience of our institution within the trial will be discussed.
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