RESUMO -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.PALAVRAS-CHAVE: carótida, estenose, doença ateromatosa, angioplastia, "stent", proteção cerebral, embolia cerebral, acidente vascular cerebral.The cerebral protection technique in angioplasty plus stenting of carotid: an effective procedure against The cerebral protection technique in angioplasty plus stenting of carotid: an effective procedure against The cerebral protection technique in angioplasty plus stenting of carotid: an effective procedure against The cerebral protection technique in angioplasty plus stenting of carotid: an effective procedure against The cerebral protection technique in angioplasty plus stenting of carotid: an effective procedure against cerebral embolism cerebral embolism cerebral embolism cerebral embolism cerebral embolism ABSTRACT -Objective: To describe the cerebral protection technique used in the angioplasty and stenting to treat stenotic lesions of carotid artery bifurcation, showing its efficiency in avoiding cerebral emboli during the procedure. Method: Forty two patients (47 arteries) were treated with the cerebral protection technique, which consists in the temporary occlusion of the internal carotid artery, above the stenotic lesion, performing the aspiration and flushing of glucose solution into the internal carotid artery after the delivery of the stent and the angioplasty, to remove any atherosclerotic plaque's fragments. Results: The angioplasty was efficient in all cases. There were no cerebral emboli in the patients in whom the complete cerebral protection technique was used, showing its efficiency . Distal embolism occurred in one patient, during pre angioplasty and before the use of cerebral protection. Conclusion: The cerebral protection technique was efficient to avoid cerebral emboli in the procedures performed. This data is in agreement with the literature and the use of this technique increases the indications of carotid angioplasty.KEY WORDS: carotid, stenoses, atherosclerotic disease...
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