Factors Related to Non-participation in the Basque Country Colorectal Cancer Screening Programme.

Background: Despite the high participation rates in the Basque Country, colorectal cancer screening programme (Spain), there is still a part of the population that has never participated. Since it is essential to ensure equal access to health services, it is necessary to identify the determinants of health and socio-economic factors related to non-participation in the screening programme. Methods: Cross sectional descriptive study including all invited population in a complete round between 2015 and the first trimester of 2017. Health risk factors available in medical records and their control have been analyzed using univariate and multivariate analyses. Results: 515,388 people were invited at the programme with a 71.9% of fecal immunochemical test participation rate. Factors that increase the risk of non-participation are: being men (OR = 1.10, 95% CI 1.09-1.12); younger than 60 (OR = 1.18, 95% CI 1.17-1.20); smoker (OR = 1.20, 95% CI 1.18-1.22); hypertensive (OR = 1.14, 95% CI 1.12-1.15) and diabetic (OR = 1.40, 95% CI 1.36-1.43); having severe comorbidity (OR = 2.09, 95% CI 2.00-2.19) and very high deprivation (OR = 1.15, 95% CI 1.12-1.17), as well as making <6 appointments to Primary Care in 3 years (OR = 2.39, 95% CI 2.33-2.45). Still, the area under the curve (AUC) indicates that there are more factors related to non-participation. Conclusions: The participation in the Basque Country colorectal cancer-screening Programme is related to some risk factors controlled by Primary Care among others. Therefore, the involvement of these professionals could improve, not only the adherence to the CRC screening, but also other health styles and preventive interventions.

Utility of the EAT-10 in the detection of dysphagia in high-risk hospitalisation units at a university hospital: a cross-sectional study.

INTRODUCTION: Introduction: the objective was to assess the utility of the Eating Assessment Tool (EAT-10) in hospitalisation units with patients at high risk of dysphagia. Patients and methods: a cross-sectional study was conducted in the Neurology and Internal Medicine wards; patients with admission < 24 hours and in a terminal stage of disease were excluded. In the first 24-48 hours of admission the presence of dysphagia as assessed with the EAT-10, the risk of malnutrition as assessed with the Malnutrition Universal Screening Tools (MUST), and comorbidities using the Charlson index were screened. Results: a total of 169 patients were recruited (76.0 years, 52 % women); 19.5 % were at risk of malnutrition. The EAT-10 instrument could be administered in 80.6 % of the patients, and was positive in 26.6 % (women 34.1 % vs. men 18.4 %; p = 0.025). When comparing patients with higher comorbidity with those with a lower Charlson index, a lower response rate to EAT-10 was observed (78.4 % vs. 93.9 %; p = 0.038), without differences in screening positivity (28.3 % vs. 19.4 %; p = 0.310). The prevalence of dysphagia risk was higher in the Internal Medicine unit than in the Neurology unit (30.4 % vs. 19.6 %; p = 0.133), as was the percentage of cases in which screening could not be performed (21.1 % vs. 11.1 %; p = 0.011). There were no significant differences in risk of malnutrition, mortality, hospital stay, or readmission according to the EAT-10. Conclusions: The EAT-10 has limited utility in the studied hospitalisation units due to a high rate of unfeasible tests, especially among patients at higher risk of dysphagia.

INTRODUCCIÓN: Introducción: el objetivo del estudio fue evaluar la utilidad del Eating Assessment Tool (EAT-10) en unidades de hospitalización con pacientes de alto riesgo de disfagia. Pacientes y métodos: estudio transversal de pacientes hospitalizados en Medicina Interna y Neurología; los pacientes con ingreso < 24 horas y en fase terminal de la enfermedad fueron excluidos. En las primeras 24-48 horas de ingreso se cribó la disfagia con el EAT-10, el riesgo de desnutrición con el Malnutrition Universal Screening Tool (MUST) y la comorbilidad con el índice de Charlson. Resultados: se reclutaron 196 pacientes (76,0 años, 52 % mujeres). El 19,5 % estaban en riesgo de desnutrición. El EAT-10 se pudo realizar en el 80,6 % de la muestra y fue positivo en el 26,6 % (mujeres 34,1 % vs. hombres 18,4 %; p = 0,025). Al comparar a los pacientes con mayor comorbilidad con aquellos que tenían un índice de Charlson más bajo, se observó una tasa de respuesta más baja al EAT-10 (78,4 % vs. 93,9 %; p = 0,038), sin diferencias en la positividad del cribado (28,3 % vs. 19,4 %; p = 0,310). La prevalencia del riesgo de disfagia fue mayor en la unidad de Medicina Interna que en la de Neurología (30,4 % vs. 19,6 %; p = 0,133), así como el número de casos en que no se pudo realizar el cribado (21,1 % vs. 11,1 %; p = 0,011). No hubo diferencias significativas en el riesgo de desnutrición, mortalidad, estancia hospitalaria o reingreso según el EAT-10. Conclusiones: el EAT-10 tiene una utilidad limitada en las unidades de hospitalización estudiadas debido a una alta tasa de pruebas no realizables, especialmente entre los pacientes con mayor riesgo de disfagia.

Lipedematous scalp. A rare entity in the pediatric ageLipedema de cuero cabelludo: una entidad infrecuente en pediatría.

Lipedematous scalp is an uncommon entity of unknown etiology, rarely described in the pediatric age. It is characterized by boggy thickening of the scalp predominantly located at the vertex and occiput, which acquires a cotton-like consistency. This condition is palpable rather than visible. It is a casual finding because it is usually asymptomatic, although it may involve alopecia, pruritus, or dysesthesia. We report a 10-year-old girl with lipedematous scalp without alopecia. Sonographic and MRI findings confirmed the diagnosis of lipidematous scalp.  El lipedema de cuero cabelludo o cuero cabelludo lipedematoso es una entidad infrecuente y de etiología desconocida, rara vez descrita en la edad pediátrica. Se caracteriza por un engrosamiento difuso y de tacto esponjoso del tejido celular subcutáneo localizado principalmente en vértex y occipucio. Suele ser un hallazgo casual dado que habitualmente cursa de forma asintomática, aunque puede asociar alopecia, prurito o disestesias. Presentamos el caso de una niña de 10 años de edad con lipedema de cuero cabelludo sin alopecia asociada. Los hallazgos ecográficos y de resonancia magnética confirmaron el diagnóstico de lipedema de cuero cabelludo.

Estimation of the real burden of invasive meningococcal disease in Argentina.

Among the different existing types of bacterial meningitis, the one caused by Neisseria meningitidis is the main presentation of invasive meningococcal disease (IMD). IMD is a significant public health concern and has a reported incidence rate in Argentina of 0.44 cases per 100 000 inhabitants in 2015. However, the actual incidence is thought to be higher as passive surveillance systems neither report nor identify 100% of all cases. The aim of this study is to develop an estimation of the burden of IMD in Argentina closer to reality by adjusting/correcting several limitations observed in the surveillance data available. A retrospective observational study has been performed using four Argentinean national databases recording the number of IMD cases and deaths, serogroups of N. meningitidis and ages, between 2007 to 2016. The reported data were adjusted to account for underreporting and to also integrate the cases missed due to well-known limitations associated with the diagnosis of N. meningitidis detection methods. Data were further analysed by serogroups of N. meningitidis and by age groups. After these adjustments, the potential numbers of IMD cases and IMD-related deaths are estimated to be 3.1 and 1.9 higher than reported, respectively. The study corrects the previous underestimation of the disease burden and provides expectedly more robust estimates aligned with international evidence and highlights the importance of active surveillance, with high-quality methods, for a better definition of preventive strategies against IMD in Argentina.

Aplasia cutis congénita con defecto óseo subyacente: evolución favorable tras manejo conservador.

La aplasia cutis congénita es una rara alteración caracterizada por la ausencia de áreas localizadas de piel en el momento del nacimiento. Suele manifestarse como una lesión solitaria localizada principalmente en el cuero cabelludo, que puede estar asociada con otras malformaciones congénitas. Las complicaciones pueden ser fatales, por lo que es necesario un tratamiento individualizado que vendrá determinado por el tamaño, localización y grado de afectación de estructuras subyacentes. Presentamos un caso de aplasia cutis congénita del cuero cabelludo con múltiples lesiones y defecto óseo subyacente de 3 × 1.5 cm de tamaño, pero sin otras anomalías asociadas. El manejo conservador permitió una adecuada y completa epitelización cutánea con cierre del defecto óseo subyacente sin necesidad de procedimientos invasivos.

Meningococcal carriage prevalence in university students, 1824 years of age in Santiago, Chile.

INTRODUCTION: Neisseria meningitidis invasive disease is a major public health problem. Pharyngeal carriage is considered a prerequisite for invasive infection. Prevalence reaches 10% in general population and up to 30% in the 20-24 years age group. The aim of this study was to asses pharyngeal carriage prevalence in healthy subjects aged 18-24 years, and as secondary endpoints evaluate known risk factors, to identify serogroups and sequence in the isolated strains. METHODS: Cross-sectional study in 500 healthy subjects; students from Universidad de Chile aged 18-24 years, Santiago, Chile, October 2012. Each subject underwent a risk factor survey prior to throat culture sampling. Samples were processed in one central Microbiology Laboratory of Hospital Luis Calvo Mackenna and serogrouping and sequencing was performed at Instituto de Salud Pública de Chile. RESULTS: We obtained throat samples from 500 healthy subjects, 20 (4%) positive for N. meningitidis. Of positive strains 20% were serogroup B, 15% W and the rest non groupable. The median age was 20 years, 50% were men. Of the risk factors evaluated, 24% were current smokers, 16% shared a room, 72% had kissed someone during the last month, 64% had gone to pub and 76% had consumed alcohol in the same period of time. DISCUSSION: Literatures meningococcal carriage prevalence reaches up to 30% in people aged 18-24 years. Prevalence in our study was 4%. Different interpretations could be given; one could be the absence of overcrowding in our students because of the lack of dorms in our scholar system and also the characteristics of our enrolled group. CONCLUSIONS: Our results suggest the necessity to extend the study to other age groups and to other cities, to better understand the Chilean reality, as well as others regions of America, considering that these results cannot be extrapolated to another countries.

Necrosis focal de la grasa intraabdominal / Intra-abdominal focal fat necrosis

No disponible

Mal agudo de montaña: parámetros predictivos de un mejor rendimiento en montañismo de altura / Acute mountain sickness: predictors of climbers’ performance at high altitudes

Objetivo: En el volcán Llullaillaco (6.739 m) situado en Argentina, se determinó la asociación entre los niveles de ácido láitico (AL), presión arterial (PA), frecuencia cardiaca(FC), frecuencia respiratoria (FR) y saturación O2 periférica (SaO2) con el rendimiento físico y el desarrollo de mal agudo de montaña (MAM). Métodos: A 8 escaladores se les midió el AL en sangre y los parámetros clínicos durante su ascenso al volcán. Se completó con datos de oximetría, agudeza visual (Pelli Robson), puntuación clínica de MAM de Lake Louise y test de caminata a los 6 minutos. Resultados: A los 5.000 m un AL 2 mmol/l predijo mala evolución del estado clínico a mayores alturas, progresión a MAM y empeoramiento del rendimiento deportivo (valor predictivo positivo 66,7%, valor predictivo negativo 100%, exactitud 87,5%). Un cambio en la FC 20 lpm y en la SaO2 10% en el test de caminatas a 5.000 m de altura tenían una sensibilidad y especificidad del 100% para evidenciar mala evolución en campamentos de altura. Así mismo se comprobó que una puntuación de Lake Louise 4 a los 5.000 m determinaba una mala evolución en alturas mayores por acentuar el MAM. Conclusión: La medición de parámetros clínicos y de laboratorio en los escaladores en campamentos bases podría predecir la evolución a mayores alturas. A los 5.000 m unAL 2 mmol/l, un cambio en SaO2 > 10% en el test de caminata y una puntuación de MAM de Lake Louise 4 predicen de forma significativa una mala evolución clínica (AU)

Objective: To determine the relationship between climber variables (lactic acid levels, blood pressure, heart rate, respiratory frequency, and peripheral oxygen saturation [SaO2] and their physical performance and development of acute mountain sickness (AMS) on the Llullaillaco volcano (6739 m) in Argentina. Material and methods: As 8 climbers ascended the mountain, we measured lactic acid and other clinical variables, including SaO2. We also assessed visual acuity (Pelli-Robson chart), AMS (Lake Louise scoring). SaO2 and heart rate were assessed at rest and on a 6-minute walk test. Results: Lactic acid levels of 2 mmol/L or more at 5000 m predicted worsening of a climber’s condition at higher altitudes, progression to AMS, and declining performance (positive predictive value, 66.7%; negative predictive value,100%; precision, 87.5%). Values on performance of the 6-minute walk test at 5000 m showed that a change of 20beats/min in heart rate and a 10% change in SaO2 predicted worsening condition at higher altitudes (specificity, 100%).Likewise, a Lake Louise score of 4 or more at 5000 m also predicted worsening climber condition and AMS. Conclusions: Clinical variables and laboratory findings for mountain climbers in base camps can predict their performance at higher altitudes. A lactic acid level of 2 mmol/L or more, a change in SaO2 of more than 10% after the walk test and a Lake Louise score of 4 or more predicted worsening of clinical signs (AU)

Investigational study of tamoxifen phase I metabolites using chromatographic and spectroscopic analytical techniques.

A comprehensive overview is presented of currently known phase I metabolites of tamoxifen consisting of their systematic name and molecular structure. Reference standards are utilized to elucidate the MS(n) fragmentation patterns of these metabolites using a linear ion trap mass spectrometer. UV-absorption spectra are recorded and absorption maxima are defined. Serum extracts from ten breast cancer patients receiving 40mg tamoxifen once daily were qualitatively analyzed for tamoxifen phase I metabolites using a liquid chromatography-tandem mass spectrometry set-up. In total, 19 metabolites have been identified in these serum samples. Additionally a synthetic method for the preparation of the putative metabolite 3',4'-dihydroxytamoxifen is described.

[Antimicrobial susceptibility, capsular serotypes and clonal relationship of invasive streptococcus pneumoniae isolates in adult population of the Bio-Bio region, Chile. 2005-2006]. / Susceptibilidad antimicrobiana, serotipos capsulares y relación clonal entre cepas invasoras de streptococcus pneumoniae aisladas de pacientes adultos de la Región del Bío-Bío, Chile. Periodo 2005-2006.

Streptococcus pneumoniae infections constitute a public health problem. In our country there is scarce information regarding isolates from bacteraemic episodes in adult population. The antibiotic susceptibility, serotypes and clonal relationship of 56 isolates of S. pneumoniae from adult patients with bacteraemic infections in Concepcion-Talcahuano, Bio-Bio Region, Chile, were studied. Resistance to tetracycline (21.4%), trimethoprim/ sulfamethoxazole (18%), erythromycin (18%), chloramphenicol (7%) and 1 penicillin resistant isolate from a meningeal focus (2%) was found. Also, all the isolates were susceptible to cefotaxime, levofloxacin, moxifloxacin and vancomycin. A wide variety of capsular serotypes was demonstrated, with predominance of serotypes 1, 5, 23F, 7F and 3. The macrorestriction analysis by pulse field electrophoresis revealed 31 electrophoretic patterns and 12 clonal groups, discarding a predominant clone. According to the results, at least, 80% of the S. pneumoniae serotypes isolated from bacteraemic adult patients are included in the available commercial vaccine.

Susceptibilidad antimicrobiana, serotipos capsulares y relación clonal entre cepas invasoras de Streptococcus pneumoniae aisladas de pacientes adultos de la Región del Bío-Bío, Chile: Período 2005-2006 / Antimicrobial susceptibility, capsular serotypes and clonal relationship of invasive Streptococcus pneumoniae isolates in adult population of the Bio-Bio Region, Chile: 2005-2006

Las infecciones ocasionadas por Streptococcus pneumoniae constituyen un problema de salud pública. En nuestro país existe escasa información sobre aislados de procesos bacteriémicos en población adulta. Se estudió la susceptibilidad, serotipos y relación clonal de 56 aislados de S. pneumoniae desde hemocultivos, entre enero 2005 y agosto 2006, de pacientes adultos de la intercomuna Concepción-Talcahuano, Región del Bío-Bío, Chile. Se encontró resistencia a tetraciclina (21,4 por ciento), cotrimoxazol (18 por ciento), eritromicina (18 por ciento), cloranfenicol (7 por ciento) y a penicilina en un solo aislado procedente de un foco meníngeo (2 por ciento). La totalidad mostró susceptibilidad a cefotaxima, levofloxacina, moxifloxacina y vancomicina. Se demostró una amplia variedad de serotipos capsulares, con predominio de los serotipos 1, 5, 23F, 7F y 3. El análisis de macrorestricción y electroforesis en campo pulsado reveló 31 patrones electroforéticos con 12 grupos clona-les, descartando un clon predominante. De acuerdo a los resultados, al menos 80 por ciento de los serotipos de aislados de S. pneumoniae de procesos bacteriémicos están incluidos en la vacuna comercial disponible.

Streptococcus pneumoniae infections constitute a public health problem. In our country there is scarce information regarding isolates from bacteraemic episodes in adult population. The antibiotic susceptibility, sero-types and clonal relationship of 56 isolates of S. pneumoniae from adult patients with bacteraemic infections in Concepcion-Talcahuano, Bio-Bio Region, Chile, were studied. Resistance to tetracycline (21.4 percent), trimethoprim/ sulfamethoxazole (18 percent), erythromycin (18 percent), chloramphenicol (7 percent) and 1 penicillin resistant isolate from a meningeal focus (2 percent) was found. Also, all the isolates were susceptible to cefotaxime, levofloxacin, moxifloxacin and vancomycin. A wide variety of capsular serotypes was demonstrated, with predominance of serotypes 1, 5, 23F, 7F and 3. The macrorestriction analysis by pulse field electrophoresis revealed 31 electrophoretic patterns and 12 clonal groups, discarding a predominant clone. According to the results, at least, 80 percent of the S. pneumoniae serotypes isolated from bacteraemic adult patients are included in the available commercial vaccine.

Polyisoprene matrix for progesterone release: in vitro and in vivo studies.

Latex, a polyisoprene (PI) hydrophobic elastomer, was evaluated in vitro and in vivo as a matrix for intravaginal steroid hormone delivery. Matrices containing hormone were prepared by swelling latex in chloroform that contained soluble progesterone (P4). In vitro studies demonstrate that P4 release from PI follows a zero order model during at least 100 h and depends on initial load up to 10 mg cm(-2). The release of P4 from a PI matrix was found to be two times faster than from a polydimethylsiloxane (PDMS) matrix. FT-IR and X-ray powder diffraction analysis of P4 polymorphs show that when nucleated in PDMS, the hormone crystallizes only in alpha-form while in latex, crystallizes as a mixture of alpha- and beta-form. In vivo studies show that devices with a PI matrix containing 0.5 g of P4 are effective to reach plasma levels above 1 ng ml(-1) that are needed to synchronize estrous in cattle. Altogether, the results show that PI, a vulcanized polymer with a carbon-carbon backbone, can be used as a new matrix for the intravaginal administration of progesterone with improved release profile than silicone and that the matrix can influence the crystalline state of the hormone.

Interventional radiologist treatment for inferior vena caval thrombosis in a liver transplant recipient.

Vascular complications remain an important cause of postoperative morbidity and mortality in liver transplant patients. There is no elective treatment and the need for retransplantation is common. Herein, we have reported an unusual case of nonanastomotic inferior vena cava thrombosis in a patient with a piggyback caval anastomosis. The conditions was successfully treated with catheter-directed thrombolytic therapy and endovascular stent placement.

MALDI-TOF MS analysis of labile Lolium perenne major allergens in mixes.

BACKGROUND: It is well known that allergen extracts used for specific therapy of allergic disorders are commonly stored as mixtures, causing an alteration of its stability. OBJECTIVE: The aim of this report is to identify pollen allergens susceptible to degradation during storage of mixtures containing different sources of proteases in the absence of glycerol as a preserving agent. METHODS: Mixes containing Lolium perenne (Lol p) pollen extract with either Aspergillus fumigatus or Periplaneta americana extracts were prepared and co-incubated for 90 days at 4 degrees C. Samples were taken off at fixed times and comparatively tested by in vitro and in vivo assays with atopic patients. Selected pollinic allergens were subjected to MALDI-TOF MS analysis. RESULTS: ELISA inhibition evidenced the loss of potency from ryegrass extract, and immunoblotting assays showed the degradation of specific pollinic allergens during storage of mixtures containing protease-rich sources. An in vivo intradermal skin assay confirmed the gradual loss of the biological activity of L. perenne pollen extract co-incubated with non-related protease-rich extracts in comparison with that of the control pollen extract. MALDI-TOF MS analysis allowed us to determine that Lol p 1 and Lol p 5 are susceptible to proteolysis whereas Lol p 4 was found to be resistant to degradation during storage. CONCLUSIONS: Lol p 1 and Lol p 5 degradation is responsible for the loss of the biological activity of L. perenne pollen extract when co-incubated with protease-rich fungal and cockroach extracts in the same vial for months in the absence of glycerol as a preserving agent. The integrity of these major allergens must be preserved to increase the vaccine stability and to assure efficacy when mixes are used for immunotherapy.

[Endovascular treatment of carotid disease in patients at high surgical risk]. / Tratamiento endovascular de la enfermedad carotídea en pacientes de alto riesgo.

AIMS: To analyse the perioperative morbi-mortality rates during the first 30 days following endovascular therapy in patients with carotid stenosis and important risk factors for surgery. We also sought to determine the survival rate, the percentage of patients that were stroke-free and the percentage of cases of restenosis during the follow-up period. PATIENTS AND METHODS: A retrospective study was conducted on a series of 100 patients with symptomatic > 50% and asymptomatic > 70% carotid stenosis, who underwent endovascular therapy between January 2000 and December 2006 because of the important risk factors they presented. Monitoring was clinical and was performed by means of carotid Doppler scanning. RESULTS: The mean age of the sample: 72.2 years (46-86). Perioperative morbi-mortality of the series: 6% (confidence interval, CI 95% = 0.8-11.2) and in the symptomatic stenosis group: 5.7% (CI 95% = 1.8-12.9). The mean follow-up time was 23.4 months (0-94). Total mortality of the series during the follow-up was 7% (CI 95% = 1.4-12.5). The probability of survival at 3 and 5 years is 93 and 89%, respectively. At one year, 98.9% of the patients remained stroke-free. Restenosis of the stent occurred in 5% (CI 95% = 1.6-11.2). The probability of restenosis not occurring was 96.75% at 6 months and 94% at 3 years. CONCLUSIONS: Stent angioplasty is an effective form of treatment in carotid stenosis in patients with important risk factors for surgery and it is therefore important to fulfil patient selection protocols and avoid perioperative complications.

Tratamiento endovascular de la enfermedad carotídea en pacientes de alto riesgo / Endovascular treatment of carotid disease in patients at high surgical risk

Analizar la morbimortalidad perioperatoria durante los primeros 30 días tras la terapia endovascularen pacientes con estenosis carotídea e importantes factores de riesgo para la cirugía, y determinar la supervivencia, el porcentaje de pacientes libres de ictus, así como el porcentaje de reestenosis durante el tiempo de seguimiento. Pacientes y métodos.Se ha realizado un estudio retrospectivo de una serie de 100 pacientes con estenosis carotídeas sintomáticas > 50% y asintomáticas > 70% a los que se realizó terapia endovascular entre enero de 2000 y diciembre de 2006 por presentar importantes factores de riesgo. El seguimiento ha sido clínico mediante Doppler carotídeo. Resultados. Media de edad de la muestra: 72,2 años (rango: 46-86 años). Morbimortalidad perioperatoria de la serie: 6% (IC 95% = 0,8-11,2) y en el grupo de estenosissintomática: 5,7% (IC 95% = 1,8-12,9). El tiempo medio de seguimiento fue de 23,4 meses (rango: 0-94 meses). Lamortalidad total de la serie durante el seguimiento fue del 7% (IC 95% = 1,4-12,5). La probabilidad de supervivencia a los 3 y 5 años es del 93% y 89%, respectivamente. El 98,9% ha permanecido libre de ictus al año. Se produjo reestenosis del stenten el 5% (IC 95% = 1,6-11,2). La probabilidad de que no se produzca reestenosis es del 96,75% a los 6 meses y del 94% a los 3 años. Conclusiones. La angioplastia con stent es un tratamiento efectivo en estenosis carotídea en pacientes con importantes factores de riesgo para la cirugía, de ahí la importancia de realizar protocolos de selección de pacientes y evitar las complicaciones periprocedimiento

To analyse the perioperative morbi-mortality rates during the first 30 days following endovascular therapyin patients with carotid stenosis and important risk factors for surgery. We also sought to determine the survival rate, the percentage of patients that were stroke-free and the percentage of cases of restenosis during the follow-up period. Patients andmethods. A retrospective study was conducted on a series of 100 patients with symptomatic > 50% and asymptomatic > 70% carotid stenosis, who underwent endovascular therapy between January 2000 and December 2006 because of the important risk factors they presented. Monitoring was clinical and was performed by means of carotid Doppler scanning. Results. The mean age of the sample: 72.2 years (46-86). Perioperative morbi-mortality of the series: 6% (confidence interval, CI 95% =0.8-11.2) and in the symptomatic stenosis group: 5.7% (CI 95% = 1.8-12.9). The mean follow-up time was 23.4 months (0-94). Total mortality of the series during the follow-up was 7% (CI 95% = 1.4-12.5). The probability of survival at 3 and 5 years is 93 and 89%, respectively. At one year, 98.9% of the patients remained stroke-free. Restenosis of the stent occurred in 5% (CI95% = 1.6-11.2). The probability of restenosis not occurring was 96.75% at 6 months and 94% at 3 years. Conclusions. Stent angioplasty is an effective form of treatment in carotid stenosis in patients with important risk factors for surgery and it istherefore important to fulfil patient selection protocols and avoid perioperative complications (AU)