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Časopis Neurology – Článok Risk reduction of brain infarction during carotid endarterectomy and stenting using sonolysis

Neurology

Reviewed, postgraduate scietific medical journal.
Period 3x per year
1336-8621
The journal is indexed in the Slovak National Bibliography, Bibliographiia Medica Slovaca (BMS) and listed to citation database CiBaMed. All articles are reviewed. The publisher does not bear any responsibility for data and opinions of particular authors of the articles or advertisements. The articles on grey pages are company promotions or non reviewed information, an author is responsible for the content. Any reproduction of the content is allowed only with direct consent of the editorial office.
Predplatné
Neurology
Neurology
Reviewed, postgraduate scietific medical journal.
Period 3x per year
Téma: Original Works

Risk reduction of brain infarction during carotid endarterectomy and stenting using sonolysis

Martin Kuliha1,2, Martin Roubec1, Eva Hurtíková1, Andrea Goldírová1,3, Roman Herzig4, Václav Procházka5, Tomáš Jonszta5, Jan Krajča5, Dan Czerný5, Tomáš Hrbáč6, David Otáhal6, Daniel Šaňák7, Michal Král7, Kateřina Langová8, David Školoudík1,2,3

Induction: Sonolysis is a new therapeutic option for the acceleration of arterial recanalization. The aim of this study was to confirm a risk reduction of brain infarction during carotid endarterectomy (CEA) and stenting (CAS) using sonolysis with continuous transcranial Doppler (TCD) monitoring by diagnostic 2 MHz probe. Methods: All consecutive patients with internal carotid artery ICA stenosis > 70 %, indicated to CEA or CAS and with signed informed consent, were enrolled to the prospective study during 24 months. Patients were randomized into 2 groups: Group 1 with sonolysis during intervention and Group 2 without sonolysis. Neurological examination, assessment of cognitive functions and brain magnetic resonance imaging (MRI) were performed before and 24 hours after intervention in all patients. Occurrence of new brain infarctions (including infarctions > 0.5 cm3), and the results of Mini-Mental State Examination, Clock Drawing and Verbal Fluency tests were statistically evaluated. Results: Totally 127 patients (87 males, mean age 65.6 ± 7.7 years) were included into the study. Out of the 62 patients randomized to sonolysis group (Group 1), 33 underwent CEA (Group 1a) and 29 CAS (Group 1b). Out of the 65 patients randomized to control group (Group 2), 30 underwent CEA (Group 2a) and 35 CAS (Group 2b). New ischemic brain infarctions on follow up MRI were found in 19 (30.6 %) patients in Group 1; 6 (18.2 %) patients in Group 1a and 13 (44.8 %) in Group 1b. In Group 2, new ischemic brain infarctions were found in 26 (40.0 %) patients; 8 (26.7 %) in Group 2a and 18 (51.4 %) in Group 2b (p > 0.05 in all cases). New ischemic brain infarctions > 0.5 cm3 were found in 5 (8.1 %) patients in Group 1 and in 12 (18.5 %) patients in Group 2 (p = 0.046). No significant differences were found in cognitive tests results between groups (p > 0.05 in all tests). Conclusion: Patients with sonolysis during CEA and CAS had significantly lower risk of new ischemic lesions on MR after intervention in comparison with control group. Sonolysis seems to be effective in the prevention of large ischemic brain infarctions during CEA and CAS.

Neurológia 2014; 9 (3): 151-156

Ročník 2014  Témy časopisu Neurology 3 / 2014

Original Works

Original Works

Case Studies

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doc. MUDr. Miroslav Brozman, CSc.

MEMBERS OF THE EDITORIAL BOARD
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doc. MUDr. Eleonóra Klímová, CSc.
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MUDr. Marian Kuchar, PhD.
doc. MUDr. Robert Mikulík,Ph.D., FESO
MUDr. Vladimír Nosáľ, PhD.
MUDr. Ľubica Procházková, CSc.
prof. MUDr. Bruno Rudinský, CSc.
doc. MUDr. Daniel Šaňák, Ph.D.
doc. MUDr. David Školoudík, Ph.D., FESO
prof. MUDr. Karel Šonka, DrSc.
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Dr. Milan R. Voško, PhD.

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2. Stenestrand U, Wallentin L. Swedish Register of Cardiac Intensive Care (RIKS-HIA): Early statin treatment following acute myocardial infarction and 1-year survival. JAMA 2001; 285(4): 430-436.
3. LIPID Study Group. Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. N Engl J Med 1998; 339: 1349-1357.
4. Jurkovičová O, Spitzerová H, Cagáň S. Komorové arytmie a náhla srdcová smrť pri akútnom infarkte myokardu. Bratisl Lek Listy 1997; 98: 379-389.
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Which of following factors is not related to rosacea?
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Period 3x per year
1336-8621
The journal is indexed in the Slovak National Bibliography, Bibliographiia Medica Slovaca (BMS) and listed to citation database CiBaMed. All articles are reviewed. The publisher does not bear any responsibility for data and opinions of particular authors of the articles or advertisements. The articles on grey pages are company promotions or non reviewed information, an author is responsible for the content. Any reproduction of the content is allowed only with direct consent of the editorial office.
Predplatné
Neurology
Neurology
Reviewed, postgraduate scietific medical journal.
Period 3x per year