{"id":9516,"date":"2024-06-18T19:31:58","date_gmt":"2024-06-18T16:31:58","guid":{"rendered":"https:\/\/ozgurkilickesmez.com\/?p=9516"},"modified":"2025-09-04T20:57:00","modified_gmt":"2025-09-04T17:57:00","slug":"tratamentul-stenozei-carotide-arteria-carotida-cu-stenturi","status":"publish","type":"post","link":"https:\/\/ozgurkilickesmez.com\/ro\/tratamentul-stenozei-carotide-arteria-carotida-cu-stenturi\/","title":{"rendered":"Tratamentul stenozei carotide (arteria carotid\u0103) cu stenturi"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">Tratamentul stenozei carotide cu stenturi const\u0103 \u00een dilatarea arterei \u00eengustate \u0219i plasarea unui stent pentru a restabili fluxul sangvin cerebral. Aceast\u0103 metod\u0103 previne accidentele vasculare ischemice.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Procedura se efectueaz\u0103 endovascular, sub ghidaj radiologic, \u0219i este o alternativ\u0103 sigur\u0103 la endarterectomia chirurgical\u0103. Recuperarea este rapid\u0103, cu spitalizare redus\u0103.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Pacien\u021bii cu stenoz\u0103 carotidian\u0103 beneficiaz\u0103 de reducerea riscului de AVC, ameliorarea fluxului cerebral \u0219i protec\u021bia pe termen lung. Interven\u021bia este minim invaziv\u0103 \u0219i bine tolerat\u0103.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Indica\u021biile includ \u00eengust\u0103rile semnificative ale arterei carotide, confirmate imagistic. Alegerea tratamentului cu stenturi se face individualizat, \u00een func\u021bie de profilul pacientului \u0219i riscurile asociate.<\/span><\/p>\n<table dir=\"ltr\" border=\"1\" cellspacing=\"0\" cellpadding=\"0\" data-sheets-root=\"1\">\n<colgroup>\n<col width=\"179\" \/>\n<col width=\"337\" \/><\/colgroup>\n<tbody>\n<tr>\n<td style=\"text-align: center;\" colspan=\"2\" rowspan=\"1\" data-sheets-value=\"{&quot;1&quot;:2,&quot;2&quot;:&quot;Kategori&quot;}\"><strong>Ce trebuie s\u0103 \u0219tii despre tratamentul stenozelor carotidiene cu stent<\/strong><\/td>\n<\/tr>\n<tr>\n<td data-sheets-value=\"{&quot;1&quot;:2,&quot;2&quot;:&quot;Tan\u0131m&quot;}\">Defini\u021bie<\/td>\n<td data-sheets-value=\"{&quot;1&quot;:2,&quot;2&quot;:&quot;Karotis arterlerindeki darl\u0131klar\u0131 geni\u015fletmek ve kan ak\u0131\u015f\u0131n\u0131 iyile\u015ftirmek i\u00e7in stent yerle\u015ftirilmesi i\u015flemi.&quot;}\">\n<div>\n<div>Procedura de inser\u021bie a stentului pentru dilatarea stenozelor arteriale carotidiene \u0219i \u00eembun\u0103t\u0103\u021birea fluxului sanguin.<\/div>\n<\/div>\n<\/td>\n<\/tr>\n<tr>\n<td data-sheets-value=\"{&quot;1&quot;:2,&quot;2&quot;:&quot;Endikasyonlar&quot;}\">Indica\u021bii<\/td>\n<td data-sheets-value=\"{&quot;1&quot;:2,&quot;2&quot;:&quot;Semptomatik karotis arter darl\u0131\u011f\u0131, ciddi (y\u00fczde 70-99) asemptomatik karotis darl\u0131\u011f\u0131, y\u00fcksek cerrahi riski ta\u015f\u0131yan hastalar.&quot;}\">\n<div>\n<div>Stenoz\u0103 carotidian\u0103 simptomatic\u0103, stenoz\u0103 carotidian\u0103 asimptomatic\u0103 sever\u0103 (70-99%), pacien\u021bi cu risc chirurgical ridicat.<\/div>\n<\/div>\n<\/td>\n<\/tr>\n<tr>\n<td data-sheets-value=\"{&quot;1&quot;:2,&quot;2&quot;:&quot;Kontrendikasyonlar&quot;}\">Contraindica\u021bii<\/td>\n<td data-sheets-value=\"{&quot;1&quot;:2,&quot;2&quot;:&quot;Tam arter t\u0131kan\u0131kl\u0131\u011f\u0131, ciddi kanama bozukluklar\u0131, alerjik reaksiyon riski (kontrast maddeye kar\u015f\u0131), aktif enfeksiyon.&quot;}\">\n<div>\n<div>Ocluzie arterial\u0103 complet\u0103, tulbur\u0103ri severe de coagulare, risc de reac\u021bie alergic\u0103 la agentul de contrast, infec\u021bie activ\u0103.<\/div>\n<\/div>\n<\/td>\n<\/tr>\n<tr>\n<td data-sheets-value=\"{&quot;1&quot;:2,&quot;2&quot;:&quot;Prosed\u00fcr \u00d6ncesi Haz\u0131rl\u0131k&quot;}\">Preg\u0103tiri \u00eenainte de procedur\u0103<\/td>\n<td data-sheets-value=\"{&quot;1&quot;:2,&quot;2&quot;:&quot;Kan testleri, g\u00f6r\u00fcnt\u00fcleme \u00e7al\u0131\u015fmalar\u0131 (Doppler ultrason, MR, CT anjiyografi), aspirin veya antikoag\u00fclan ba\u015flat\u0131lmas\u0131, i\u015flem \u00f6ncesi a\u00e7 kalma gereksinimi.&quot;}\">\n<div>\n<div>Teste de s\u00e2nge, studii imagistice (Doppler, RMN, CT angiografie), ini\u021bierea tratamentului cu aspirin\u0103 sau anticoagulante, necesitatea postului preprocedural.<\/div>\n<\/div>\n<\/td>\n<\/tr>\n<tr>\n<td data-sheets-value=\"{&quot;1&quot;:2,&quot;2&quot;:&quot;Prosed\u00fcr S\u00fcresi&quot;}\">Durata procedurii<\/td>\n<td data-sheets-value=\"{&quot;1&quot;:2,&quot;2&quot;:&quot;Genellikle 30 dk.&quot;}\">De obicei, 30 de minute.<\/td>\n<\/tr>\n<tr>\n<td data-sheets-value=\"{&quot;1&quot;:2,&quot;2&quot;:&quot;Anestezi T\u00fcr\u00fc&quot;}\">Tipul de anestezie<\/td>\n<td data-sheets-value=\"{&quot;1&quot;:2,&quot;2&quot;:&quot;Lokal anestezi ve sedasyon.&quot;}\">Anestezie local\u0103 \u0219i sedare.<\/td>\n<\/tr>\n<tr>\n<td data-sheets-value=\"{&quot;1&quot;:2,&quot;2&quot;:&quot;Prosed\u00fcr Ad\u0131mlar\u0131&quot;}\">Pa\u0219ii procedurii<\/td>\n<td data-sheets-value=\"{&quot;1&quot;:2,&quot;2&quot;:&quot;1. Kateterin kas\u0131k veya koldan karotis artere ilerletilmesi\\n2. Balonla darl\u0131\u011f\u0131n geni\u015fletilmesi (balon anjiyoplasti)\\n3. Stentin yerle\u015ftirilmesi ve a\u00e7\u0131lmas\u0131\\n4. Kan ak\u0131\u015f\u0131n\u0131n kontrol edilmesi ve kateterin \u00e7\u0131kar\u0131lmas\u0131&quot;}\">1. Introducerea cateterului \u00een artera carotidian\u0103 prin acces femural sau brahial<br \/>\n2. Dilatarea stenoz\u0103rii cu balon (angioplastie cu balon)<br \/>\n3. Inser\u021bia \u0219i expansiunea stentului<br \/>\n4. Controlul fluxului sanguin \u0219i retragerea cateterului<\/td>\n<\/tr>\n<tr>\n<td data-sheets-value=\"{&quot;1&quot;:2,&quot;2&quot;:&quot;Komplikasyonlar&quot;}\">Complica\u021bii<\/td>\n<td data-sheets-value=\"{&quot;1&quot;:2,&quot;2&quot;:&quot;\u0130nme, kanama, stentin yer de\u011fi\u015ftirmesi, damar hasar\u0131, enfeksiyon, alerjik reaksiyon (kontrast maddeye).&quot;}\">\n<div>\n<div>Accident vascular cerebral, s\u00e2ngerare, deplasarea stentului, leziuni vasculare, infec\u021bie, reac\u021bie alergic\u0103 la <a href=\"https:\/\/ozgurkilickesmez.com\/kontrast-madde\/\">agentul de contrast<\/a>.<\/div>\n<\/div>\n<\/td>\n<\/tr>\n<tr>\n<td data-sheets-value=\"{&quot;1&quot;:2,&quot;2&quot;:&quot;\u0130yile\u015fme S\u00fcresi&quot;}\">Timpul de recuperare<\/td>\n<td data-sheets-value=\"{&quot;1&quot;:2,&quot;2&quot;:&quot;Genellikle bir g\u00fcn. Hastanede yat\u0131\u015f s\u00fcresi 1 g\u00fcn olabilir.&quot;}\">De obicei, o zi; spitalizarea poate dura 1 zi.<\/td>\n<\/tr>\n<tr>\n<td data-sheets-value=\"{&quot;1&quot;:2,&quot;2&quot;:&quot;Ba\u015far\u0131 Oran\u0131&quot;}\">Rata de succes<\/td>\n<td data-sheets-value=\"{&quot;1&quot;:2,&quot;2&quot;:&quot;Y\u00fcksek; semptomatik hastalarda semptomlar\u0131n giderilmesi ve inme riskinin azalmas\u0131.&quot;}\">\n<div>\n<div>Ridicat\u0103; ameliorarea simptomelor la pacien\u021bii simptomatici \u0219i reducerea riscului de accident vascular cerebral.<\/div>\n<\/div>\n<\/td>\n<\/tr>\n<tr>\n<td data-sheets-value=\"{&quot;1&quot;:2,&quot;2&quot;:&quot;Alternatif Tedaviler&quot;}\">Tratament alternativ<\/td>\n<td data-sheets-value=\"{&quot;1&quot;:2,&quot;2&quot;:&quot;Karotis endarterektomi, ila\u00e7 tedavisi (statinler, antikoag\u00fclanlar), ya\u015fam tarz\u0131 de\u011fi\u015fiklikleri.&quot;}\">\n<div>\n<div>Endarterectomia carotidian\u0103, tratament medicamentos (statine, anticoagulante), modific\u0103ri ale stilului de via\u021b\u0103.<\/div>\n<\/div>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><span data-sheets-root=\"1\">\n\t<section class=\"section\" id=\"section_1464722749\">\n\t\t<div class=\"section-bg fill\" >\n\t\t\t\t\t\t\t\t\t\n\t\t\t\n\n\t\t<\/div>\n\n\t\t\n\n\t\t<div class=\"section-content relative\">\n\t\t\t\n\n<div class=\"row\"  id=\"row-1885561562\">\n\n\n\t<div id=\"col-1273609532\" class=\"col small-12 large-12\"  >\n\t\t\t\t<div class=\"col-inner\" style=\"background-color:#1c58ef;\" >\n\t\t\t\n\t\t\t\n\n<div class=\"row\"  id=\"row-798478669\">\n\n\n\t<div id=\"col-1538509001\" class=\"col medium-4 small-12 large-4\"  >\n\t\t\t\t<div class=\"col-inner\"  >\n\t\t\t\n\t\t\t\n\n\t<div class=\"img has-hover border-gorsel x md-x lg-x y md-y lg-y\" id=\"image_1727720933\">\n\t\t\t\t\t\t\t\t<div class=\"img-inner dark\" >\n\t\t\t<img decoding=\"async\" width=\"1020\" height=\"1020\" 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title=\"\">\t\t\t\t\t\t\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\n<style>\n#image_1727720933 {\n  width: 100%;\n}\n<\/style>\n\t<\/div>\n\t\n\n\n\t\t<\/div>\n\t\t\t\t\n<style>\n#col-1538509001 > .col-inner {\n  border-radius: 20px;\n}\n<\/style>\n\t<\/div>\n\n\t\n\n\t<div id=\"col-1251593431\" class=\"col medium-8 small-12 large-8\"  >\n\t\t\t\t<div class=\"col-inner dark\"  >\n\t\t\t\n\t\t\t\n\n\t<div id=\"text-1524089686\" class=\"text\">\n\t\t\n\n<p><strong>Prof. Dr. \u00d6zg\u00fcr KILI\u00c7KESMEZ<br \/><\/strong><span style=\"font-size: 65%;\"><em>Radiologie Interven\u021bional\u0103 \/ Neuroradiologie Interven\u021bional\u0103<\/em><\/span><\/p>\n\t\t\n<style>\n#text-1524089686 {\n  font-size: 1.25rem;\n}\n@media (min-width:550px) {\n  #text-1524089686 {\n    font-size: 2rem;\n  }\n}\n<\/style>\n\t<\/div>\n\t\n<p>Prof. Dr. K\u0131l\u0131\u00e7kesmez de\u021bine Certificatul de Competen\u021b\u0103 \u00een Radiologie din Turcia, Certificatul de Competen\u021b\u0103 \u00een Radiologie 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clinic\u0103 a arterelor carotidiene<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/ozgurkilickesmez.com\/ro\/tratamentul-stenozei-carotide-arteria-carotida-cu-stenturi\/#Indicatii_pentru_stentarea_arterelor_carotidiene\" >Indica\u021bii pentru stentarea arterelor carotidiene<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/ozgurkilickesmez.com\/ro\/tratamentul-stenozei-carotide-arteria-carotida-cu-stenturi\/#Riscurile_potentiale_ale_stentarii_carotidiene\" >Riscurile poten\u021biale ale stent\u0103rii carotidiene<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/ozgurkilickesmez.com\/ro\/tratamentul-stenozei-carotide-arteria-carotida-cu-stenturi\/#Evaluari_clinice_si_comparatii\" >Evalu\u0103ri clinice \u0219i compara\u021bii<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/ozgurkilickesmez.com\/ro\/tratamentul-stenozei-carotide-arteria-carotida-cu-stenturi\/#Echipa_medicala_imbunatateste_succesul_tratamentului_stenozelor_carotidiene\" >Echipa medical\u0103 \u00eembun\u0103t\u0103\u021be\u0219te succesul tratamentului stenozelor carotidiene<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/ozgurkilickesmez.com\/ro\/tratamentul-stenozei-carotide-arteria-carotida-cu-stenturi\/#Intrebari_frecvente\" >\u00centreb\u0103ri frecvente<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/ozgurkilickesmez.com\/ro\/tratamentul-stenozei-carotide-arteria-carotida-cu-stenturi\/#Resurse_suplimentare_si_documente\" >Resurse suplimentare \u0219i documente<\/a><\/li><\/ul><\/nav><\/div>\n<h2><span class=\"ez-toc-section\" id=\"Ce_este_endarterectomia_carotidiana\"><\/span>Ce este endarterectomia carotidian\u0103?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Endarterectomia carotidian\u0103 este o procedur\u0103 chirurgical\u0103 prin care pl\u0103cile din arterele carotidiene sunt \u00eendep\u0103rtate. Aceast\u0103 interven\u021bie se efectueaz\u0103 \u00een special \u00een zona cunoscut\u0103 ca &#8220;artera principal\u0103&#8221;. Printr-o incizie la nivelul g\u00e2tului se ajunge la arter\u0103. Endarterectomia carotidian\u0103 este esen\u021bial\u0103 pentru pacien\u021bii cu stenoz\u0103 sever\u0103. Procedura se realizeaz\u0103 de obicei sub anestezie local\u0103. Avantajele acestei metode includ:<\/p>\n<ul>\n<li aria-level=\"1\">\u00cendep\u0103rtarea eficient\u0103 a pl\u0103cilor cu risc,<\/li>\n<li aria-level=\"1\">Reducerea riscului de accident vascular cerebral,<\/li>\n<li aria-level=\"1\">Men\u021binerea s\u0103n\u0103t\u0103\u021bii vasculare pe termen lung.<\/li>\n<\/ul>\n<p>De\u0219i progresul \u00een chirurgia vascular\u0103 a condus la dezvoltarea tehnicilor minim invazive, endarterectomia carotidian\u0103 r\u0103m\u00e2ne larg utilizat\u0103. Totu\u0219i, odat\u0103 cu apari\u021bia tehnicilor minim invazive, alternative precum stentarea carotidian\u0103 au devenit op\u021biuni tot mai populare, oferind o recuperare rapid\u0103. Chiar dac\u0103 endarterectomia carotidian\u0103 este \u00eenc\u0103 standardul de aur \u00een anumite situa\u021bii, tratamentul trebuie personalizat \u00een func\u021bie de condi\u021bia fiec\u0103rui pacient.<br \/>\n<span data-sheets-root=\"1\">\n\t<section class=\"section\" id=\"section_369134134\">\n\t\t<div class=\"section-bg fill\" >\n\t\t\t\t\t\t\t\t\t\n\t\t\t\n\n\t\t<\/div>\n\n\t\t\n\n\t\t<div class=\"section-content relative\">\n\t\t\t\n\n<div class=\"row\"  id=\"row-365867396\">\n\n\n\t<div id=\"col-513776234\" class=\"col small-12 large-12\"  >\n\t\t\t\t<div class=\"col-inner box-shadow-2\"  >\n\t\t\t\n\t\t\t\n\n<div class=\"row\"  id=\"row-4680629\">\n\n\n\t<div id=\"col-2143812607\" class=\"col whatsapp-alani hide-for-small medium-3 small-12 large-3\"  >\n\t\t\t\t<div class=\"col-inner box-shadow-2\" style=\"background-color:rgb(37, 211, 102);\" >\n\t\t\t\n\t\t\t\n\n\t<div id=\"text-3045949157\" class=\"text\">\n\t\t\n\n<p><a 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class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n\n\n\n\t\t<\/div>\n\t\t\t\t\n<style>\n#col-257419652 > .col-inner {\n  margin: 0px 0px -60px 0px;\n}\n<\/style>\n\t<\/div>\n\n\t\n\n\t<div id=\"col-1112605757\" class=\"col small-12 large-12\"  >\n\t\t\t\t<div class=\"col-inner\"  >\n\t\t\t\n\t\t\t\n\n\t<div id=\"text-2106042967\" class=\"text\">\n\t\t\n\n<p>*V\u0103 recomand\u0103m s\u0103 completa\u021bi toate c\u00e2mpurile pentru a primi cel mai bun r\u0103spuns posibil.<\/p>\n\t\t\n<style>\n#text-2106042967 {\n  font-size: 0.85rem;\n  line-height: 1.5;\n}\n@media (min-width:550px) {\n  #text-2106042967 {\n    line-height: 0.75;\n  }\n}\n<\/style>\n\t<\/div>\n\t\n\n\t\t<\/div>\n\t\t\t\t\n<style>\n#col-1112605757 > .col-inner {\n  margin: 0px 0px -40px 0px;\n}\n<\/style>\n\t<\/div>\n\n\t\n\n<\/div>\n\n\t\t<\/div>\n\t\t\t\t\n<style>\n#col-903154980 > .col-inner {\n  padding: 0px 0px 0px 0px;\n  margin: 0px 0px -20px 0px;\n}\n@media (min-width:550px) {\n  #col-903154980 > .col-inner {\n    padding: 20px 0px 0px 0px;\n    margin: 0px 0px -66px 0px;\n  }\n}\n<\/style>\n\t<\/div>\n\n\t\n\n<\/div>\n\n\t\t<\/div>\n\t\t\t\t\n<style>\n#col-513776234 > .col-inner {\n  padding: 30px 10px 0px 10px;\n  border-radius: 30px;\n}\n@media (min-width:550px) {\n  #col-513776234 > .col-inner {\n    padding: 0px 20px 0px 0px;\n  }\n}\n<\/style>\n\t<\/div>\n\n\t\n\n<\/div>\n\n\t\t<\/div>\n\n\t\t\n<style>\n#section_369134134 {\n  padding-top: 30px;\n  padding-bottom: 30px;\n}\n<\/style>\n\t<\/section>\n\t<\/span><\/p>\n<h2><span class=\"ez-toc-section\" id=\"Caracteristicile_structurale_si_importanta_clinica_a_arterelor_carotidiene\"><\/span>Caracteristicile structurale \u0219i importan\u021ba clinic\u0103 a arterelor carotidiene<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Arterele carotidiene sunt vasele principale care asigur\u0103 circula\u021bia s\u00e2ngelui vital \u00een organism. Artera carotidian\u0103 comun\u0103 st\u00e2ng\u0103 porne\u0219te direct din arcul aortic, iar artera carotidian\u0103 comun\u0103 dreapt\u0103 \u00ee\u0219i are originea din trunchiul brachiocefalic. Ambele artere se divid \u00een artera carotidian\u0103 intern\u0103 \u0219i extern\u0103. <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK470541\/\" target=\"_blank\" rel=\"noopener\">Arterele carotidiene interne transport\u0103 s\u00e2nge c\u0103tre creier, \u00een timp ce arterele carotidiene externe alimenteaz\u0103 fa\u021ba, scalpul \u0219i zona g\u00e2tului.<\/a> Aceast\u0103 diviziune eviden\u021biaz\u0103 rolul critic al ambelor ramuri.<\/p>\n<ul>\n<li aria-level=\"1\">Arterele carotidiene interne: Transport\u0103 s\u00e2nge oxigenat c\u0103tre creier.<\/li>\n<li aria-level=\"1\">Arterele carotidiene externe: Asigur\u0103 iriga\u021bia pentru fa\u021b\u0103, scalp \u0219i g\u00e2t.<\/li>\n<\/ul>\n<p>Ambele artere formeaz\u0103 re\u021bele colaterale la diverse niveluri, oferind c\u0103i alternative de circula\u021bie \u00een caz de blocaj. Arcul aortic poate prezenta trei configura\u021bii anatomice, clasificate dup\u0103 punctele de origine ale vaselor majore:<\/p>\n<ul>\n<li aria-level=\"1\">Tip 1: Vasele majore pornesc de la cea mai superioar\u0103 parte a arcului aortic.<\/li>\n<li aria-level=\"1\">Tip 2: Originea vaselor majore corespunde celei de-a doua linii paralele.<\/li>\n<li aria-level=\"1\">Tip 3: Originea vaselor se situeaz\u0103 \u00een interiorul celei de-a treia linii paralele.<\/li>\n<\/ul>\n<p>Aceste diferen\u021be anatomice au implica\u021bii importante \u00een proceduri precum stentarea carotidian\u0103. De aceea, este esen\u021bial\u0103 evaluarea detaliat\u0103 a arcului aortic \u0219i a arterelor carotidiene pentru fiecare pacient, aspect crucial \u00een determinarea corect\u0103 a metodei de tratament.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Indicatii_pentru_stentarea_arterelor_carotidiene\"><\/span>Indica\u021bii pentru stentarea arterelor carotidiene<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><iframe title=\"Karotis (\u015eah damar\u0131) t\u0131kan\u0131kl\u0131\u011f\u0131 ila\u00e7la a\u00e7\u0131lmaz m\u0131? | Prof. Dr. \u00d6zg\u00fcr K\u0131l\u0131\u00e7kesmez\" width=\"1020\" height=\"574\" src=\"https:\/\/www.youtube.com\/embed\/16cJbsaNFgU?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe><br \/>\nPacien\u021bii cu risc chirurgical ridicat sunt candida\u021bi ideali pentru aceast\u0103 procedur\u0103. Printre factorii de risc se num\u0103r\u0103:<\/p>\n<ul>\n<li aria-level=\"1\">Pacien\u021bi cu boli pulmonare severe,<\/li>\n<li aria-level=\"1\">Cei care au suferit un infarct recent,<\/li>\n<li aria-level=\"1\">Pacien\u021bi cu angin\u0103 instabil\u0103,<\/li>\n<li aria-level=\"1\">Cei cu insuficien\u021b\u0103 cardiac\u0103 avansat\u0103.<\/li>\n<\/ul>\n<p>De asemenea, interven\u021biile anterioare \u0219i dificult\u0103\u021bile anatomice pot constitui indica\u021bii pentru stentare, cum ar fi:<\/p>\n<ul>\n<li aria-level=\"1\">Tratamentul cu radia\u021bii \u00een zona g\u00e2tului,<\/li>\n<li aria-level=\"1\">Leziuni la corzile vocale contralaterale,<\/li>\n<li aria-level=\"1\">Prezen\u021ba unei tracheostomii,<\/li>\n<li aria-level=\"1\">Stenoza carotidian\u0103 pe partea opus\u0103,<\/li>\n<li aria-level=\"1\">Stenoza recurent\u0103 dup\u0103 endarterectomia carotidian\u0103.<\/li>\n<\/ul>\n<p>Aceste condi\u021bii speciale fac ca stentarea s\u0103 fie o op\u021biune preferat\u0103.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Riscurile_potentiale_ale_stentarii_carotidiene\"><\/span>Riscurile poten\u021biale ale stent\u0103rii carotidiene<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Tratamentul stenozelor arteriale carotidiene prin stentare implic\u0103 anumite riscuri. \u00cen timpul procedurii, accesul prin artera femural\u0103 poate fi asociat cu complica\u021bii, cum ar fi:<\/p>\n<ul>\n<li aria-level=\"1\">S\u00e2ngerare<\/li>\n<li aria-level=\"1\">Perforare<\/li>\n<li aria-level=\"1\">Disec\u021bie<\/li>\n<li aria-level=\"1\">Tromboz\u0103<\/li>\n<li aria-level=\"1\">Embolizare distal\u0103<\/li>\n<\/ul>\n<p>\u00cen plus, pot ap\u0103rea dificult\u0103\u021bi \u00een timpul inser\u021biei stentului \u00een artera carotidian\u0103. Este esen\u021bial s\u0103 se evite plasarea incorect\u0103 a stentului sau fracturarea acestuia, deoarece astfel de complica\u021bii pot afecta at\u00e2t eficacitatea procedurii, c\u00e2t \u0219i procesul de recuperare. Aceste riscuri sunt luate \u00een considerare \u00een planificarea tratamentului, iar pacientul este informat detaliat.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Evaluari_clinice_si_comparatii\"><\/span>Evalu\u0103ri clinice \u0219i compara\u021bii<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Au fost realizate numeroase studii pentru a compara cele dou\u0103 metode principale de tratament ale stenozelor carotidiene: stentarea carotidian\u0103 (KAS) \u0219i endarterectomia chirurgical\u0103 (SEA). Ambele metode prezint\u0103 rate similare de restenoz\u0103 \u00een rezultatele clinice. Totu\u0219i, riscul de ischemie miocardic\u0103 este mai ridicat la SEA, \u00een timp ce riscul de accident cerebrovascular este mai frecvent la KAS. Se pare c\u0103 metoda KAS poate fi mai dificil\u0103 \u00een anumite grupuri de pacien\u021bi, \u00een special:<\/p>\n<ul>\n<li aria-level=\"1\">Pacien\u021bii cu v\u00e2rsta peste 70 de ani<\/li>\n<li aria-level=\"1\">Persoanele cu leziuni extinse de materie alb\u0103<\/li>\n<\/ul>\n<p>Pentru ace\u0219ti pacien\u021bi, KAS poate fi mai riscant comparativ cu SEA. De asemenea, abordarea transcarotidian\u0103 \u00een cadrul KAS poate reduce riscul de embolizare. Experien\u021bele clinice continue subliniaz\u0103 avantajele acestei abord\u0103ri, iar durata spitaliz\u0103rii \u0219i costurile pe termen lung sunt similare pentru ambele metode.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Echipa_medicala_imbunatateste_succesul_tratamentului_stenozelor_carotidiene\"><\/span>Echipa medical\u0103 \u00eembun\u0103t\u0103\u021be\u0219te succesul tratamentului stenozelor carotidiene<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Boala arterelor carotidiene este o afec\u021biune grav\u0103 frecvent \u00eent\u00e2lnit\u0103 \u00een practica medical\u0103 de prim\u0103 linie. \u00cen astfel de cazuri, asistentele \u0219i speciali\u0219tii \u00een medicin\u0103 intern\u0103 trimit pacien\u021bii c\u0103tre medici specializa\u021bi. Chirurgii vasculare sau radiologii interven\u021bionali aplic\u0103 metode precum inser\u021bia de stent pentru tratarea stenozelor carotidiene, acceler\u00e2nd procesul de recuperare \u0219i reduc\u00e2nd riscul de accident vascular cerebral. Dup\u0103 tratament, este esen\u021bial ca pacien\u021bii s\u0103 adopte schimb\u0103ri de stil de via\u021b\u0103, cum ar fi:<\/p>\n<ul>\n<li aria-level=\"1\">Reducerea greut\u0103\u021bii corporale,<\/li>\n<li aria-level=\"1\">Sc\u0103derea nivelului colesterolului,<\/li>\n<li aria-level=\"1\">Exerci\u021bii fizice regulate,<\/li>\n<\/ul>\n<p>aceste modific\u0103ri contribuind la prevenirea aterosclerozei \u0219i \u00eembun\u0103t\u0103\u021bind starea general\u0103 de s\u0103n\u0103tate.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Intrebari_frecvente\"><\/span>\u00centreb\u0103ri frecvente<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><img decoding=\"async\" class=\"alignnone size-full wp-image-5990\" src=\"https:\/\/ozgurkilickesmez.com\/wp-content\/uploads\/2021\/02\/sikca-sorulan-sorular.jpg\" alt=\"\" width=\"1600\" height=\"400\" title=\"\" srcset=\"https:\/\/ozgurkilickesmez.com\/wp-content\/uploads\/2021\/02\/sikca-sorulan-sorular.jpg 1600w, https:\/\/ozgurkilickesmez.com\/wp-content\/uploads\/2021\/02\/sikca-sorulan-sorular-300x75.jpg 300w, https:\/\/ozgurkilickesmez.com\/wp-content\/uploads\/2021\/02\/sikca-sorulan-sorular-1024x256.jpg 1024w, https:\/\/ozgurkilickesmez.com\/wp-content\/uploads\/2021\/02\/sikca-sorulan-sorular-1536x384.jpg 1536w\" sizes=\"(max-width: 1600px) 100vw, 1600px\" \/><br \/>\n<strong>Care sunt riscurile asociate cu inser\u021bia de stent \u00een artera carotidian\u0103?<\/strong><br \/>\n<span style=\"font-weight: 400;\">Cel mai grav risc al inser\u021biei de stent \u00een artera carotidian\u0103 este desprinderea unui fragment de cheag c\u0103tre arterele cerebrale, ceea ce poate conduce la un accident vascular cerebral temporar sau permanent. Totu\u0219i, utilizarea unui filtru de protec\u021bie \u00eempotriva cheagurilor reduce semnificativ acest risc. Printr-o interven\u021bie atent\u0103 efectuat\u0103 de neuroradiologi, riscul de accident vascular cerebral poate fi redus sub 1%. Prin urmare, stentarea este considerat\u0103 o procedur\u0103 relativ sigur\u0103, de\u0219i, ca orice interven\u021bie medical\u0103, implic\u0103 anumite riscuri.<br \/>\n<\/span><br \/>\n<strong>Ce trebuie s\u0103 observe pacientul dup\u0103 inser\u021bia de stent \u00een artera carotidian\u0103?<\/strong><br \/>\n<span style=\"font-weight: 400;\">Dup\u0103 inser\u021bia de stent, pacientul poate reveni la activit\u0103\u021bile cotidiene \u00een c\u00e2teva zile. Medicul prescrie adesea anticoagulante pe termen lung, iar respectarea acestora este esen\u021bial\u0103. De asemenea, pacientul trebuie s\u0103 renun\u021be la fumat \u0219i, dac\u0103 este necesar, s\u0103 adopte o diet\u0103 \u0219i un program de exerci\u021bii fizice pentru a regla nivelurile de lipide \u0219i zah\u0103r din s\u00e2nge. Consult\u0103rile medicale regulate sunt critice pentru monitorizarea func\u021biei stentului \u0219i a s\u0103n\u0103t\u0103\u021bii cardiovasculare, iar orice problem\u0103 trebuie semnalat\u0103 imediat.<br \/>\n<\/span><br \/>\n<strong>C\u00e2t dureaz\u0103 inser\u021bia de stent \u00een artera carotidian\u0103?<\/strong><br \/>\n<span style=\"font-weight: 400;\">Procedura de inser\u021bie a stentului dureaz\u0103, de obicei, aproximativ 30 de minute. Durata poate varia \u00een func\u021bie de complexitatea stenozelor \u0219i de localizarea acestora, astfel \u00eenc\u00e2t, \u00een anumite cazuri, procedura poate dura pu\u021bin mai mult. \u00cen majoritatea situa\u021biilor, tratamentul se finalizeaz\u0103 \u00een acest interval, astfel \u00eenc\u00e2t este important ca pacien\u021bii \u0219i medicii s\u0103 \u021bin\u0103 cont de aceast\u0103 durat\u0103.<br \/>\n<\/span><\/p>\n<h2><span class=\"ez-toc-section\" id=\"Resurse_suplimentare_si_documente\"><\/span>Resurse suplimentare \u0219i documente<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><a href=\"https:\/\/ozgurkilickesmez.com\/wp-content\/uploads\/2024\/07\/CIRSE-Standards-of-Practice-on-Carotid-Artery-Stenting.pdf\">https:\/\/ozgurkilickesmez.com\/wp-content\/uploads\/2024\/07\/CIRSE-Standards-of-Practice-on-Carotid-Artery-Stenting.pdf<\/a><br \/>\n<a href=\"https:\/\/ozgurkilickesmez.com\/wp-content\/uploads\/2024\/07\/white-et-al-2022-carotid-artery-stenting.pdf\">https:\/\/ozgurkilickesmez.com\/wp-content\/uploads\/2024\/07\/white-et-al-2022-carotid-artery-stenting.pdf<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tratamentul stenozei carotide cu stenturi const\u0103 \u00een dilatarea arterei \u00eengustate \u0219i plasarea unui stent pentru a restabili fluxul sangvin cerebral. Aceast\u0103 metod\u0103 previne accidentele vasculare ischemice. Procedura se efectueaz\u0103 endovascular, sub ghidaj radiologic, \u0219i este o alternativ\u0103 sigur\u0103 la endarterectomia chirurgical\u0103. Recuperarea este rapid\u0103, cu spitalizare redus\u0103. Pacien\u021bii cu stenoz\u0103 carotidian\u0103 beneficiaz\u0103 de reducerea riscului [&#8230;]\n","protected":false},"author":2,"featured_media":9511,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[321],"tags":[],"class_list":["post-9516","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-tratamente"],"_links":{"self":[{"href":"https:\/\/ozgurkilickesmez.com\/ro\/wp-json\/wp\/v2\/posts\/9516","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ozgurkilickesmez.com\/ro\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/ozgurkilickesmez.com\/ro\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/ozgurkilickesmez.com\/ro\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/ozgurkilickesmez.com\/ro\/wp-json\/wp\/v2\/comments?post=9516"}],"version-history":[{"count":2,"href":"https:\/\/ozgurkilickesmez.com\/ro\/wp-json\/wp\/v2\/posts\/9516\/revisions"}],"predecessor-version":[{"id":12072,"href":"https:\/\/ozgurkilickesmez.com\/ro\/wp-json\/wp\/v2\/posts\/9516\/revisions\/12072"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/ozgurkilickesmez.com\/ro\/wp-json\/wp\/v2\/media\/9511"}],"wp:attachment":[{"href":"https:\/\/ozgurkilickesmez.com\/ro\/wp-json\/wp\/v2\/media?parent=9516"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ozgurkilickesmez.com\/ro\/wp-json\/wp\/v2\/categories?post=9516"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ozgurkilickesmez.com\/ro\/wp-json\/wp\/v2\/tags?post=9516"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}