O uso de stents farmacológicos no tratamento da estenose das artérias vertebrais

Abstract

Objective: To report the feasibility and safety of percutaneous transluminal angioplasty with paclitaxel-eluting stents for management of vertebral artery stenosis in 14 patients, after two-year follow-up. Materials and Methods: Fourteen patients with a mean age of 67.2 years were submitted to endovascular treatment with placement of paclitaxel-eluting stents. The primary objective of the present study was to evaluate the safety of the procedure. The clinical effectiveness was evaluated according to the rates of restenosis and recurrence of ischemic events. Results: The initial stenosis degree ranged from 50% to 99% (mean, 73.3% ± 10.9%). The rate of technical success achieved 100%. Neither complications directly related to the procedure nor recurrence of symptoms were observed after 24-month follow-up. The rate of intra-stent restenosis was 7.1%, although asymptomatic in all the cases. Conclusion: The present study suggests that vertebral artery angioplasty with paclitaxel-eluting stents is a feasible and promising technique in terms of safety and effectiveness in the prevention of recurrent ischemia and restenosis. Keywords: Vertebral artery; Angioplasty; Stents.Objetivo: Relatar a viabilidade e segurança da angioplastia transluminal percutânea com stents recobertos com paclitaxel para tratamento de estenose de artéria vertebral em 14 pacientes, após seguimento de dois anos. Materiais e Métodos: Catorze pacientes com idade média de 67,2 anos foram submetidos a tratamento endovascular mediante angioplastia percutânea e implante de stent farmacológico. O objetivo primário deste trabalho foi assegurar a segurança do procedimento. O desfecho secundário foi a eficácia clínica, definida como sintomas isquêmicos recorrentes e taxas de reestenose. Resultados: O grau de estenose variou de 50% a 99% (média de 73,3% ± 10,9). A taxa de sucesso técnico da angioplastia foi de 100%. Não houve complicações diretamente relacionadas ao procedimento. Aos 24 meses de seguimento, nenhum paciente apresentou recorrência dos sintomas. A taxa de reestenose intra-stent foi de 7,1%, embora tenha sido assintomática na totalidade dos casos. Conclusão: Este estudo sugere que a angioplastia da artéria vertebral com o uso de stents recobertos com paclitaxel é uma técnica viável e promissora em termos de segurança e eficácia na prevenção da isquemia recorrente e reestenose. Unitermos: Artéria vertebral; Angioplastia; Stents. AbstractResumo

Evaluation of occupational and patient dose in cerebral angiography procedures

“…The technology of medical imaging, such as digital cerebral angiography and three-dimensional (3D) mapping of brain vessels, has achieved relevant advances in interventional neuroradiology. A number of recent publications in Brazil highlight the importance of neuroradiology for diagnosis and treatment of several diseases (1)(2)(3)(4)(5)(6)(7)(8)(9)(10) .…”

“…where: H O is the value of air kerma obtained from the reading of the dosimeter taped on the thyroid protector (TLD 4), converted into H P (0.07); and H U is the air kerma value obtained from the dosimeter placed under the protection apron on the chest region (TLD 5), converted into H P (10).…”

Cranial computed tomography findings in patients admitted to the emergency unit of Hospital Universitário Cajuru

“…There is a convention utilized to translate the detected voltage values into digital units, the absorption coefficient (attenuation). It is calculated in relation to the linear coefficient of water, for which the numeric value 0 is attributed, in a scale that may range from +1,000 to -1,000 Hounsfield units (HU) and is represented by a gray scale comprising a large spectrum of neuroradiology for the diagnosis and treatment of several diseases (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11) .…”