PURPOSE: To evaluate the impact of cerebral protection devices on the procedural safety and outcome of carotid stent procedures. METHODS: From June 1997 to July 2001, 275 consecutive patients (208 men; mean age 71 +/- 7.4 years) underwent percutaneous angioplasty and/or stenting of the extracranial carotid artery. In the first 125 (45.4%) patients, the procedures were performed without cerebral protection. After January 2000, protection devices were routinely used (150 [54.6%] patients), including the Angioguard filter, GuardWire occlusion system, TRAP Vascular Filtration System, EPI Filter Wire, NeuroShield, Parodi Anti-Embolism System, and Medicorp occlusive balloon. RESULTS: The percutaneous procedures were effective in 273 (99.3%) patients. No death or major stroke occurred in either group. In the unprotected group, 5 (4.0%) complications occurred: 3 (2.4%) minor strokes, 1 (0.8%) transient ischemic attack (TIA), and 1 (0.8%) subarachnoid hemorrhage. In the patients treated under cerebral protection, there were 2 (1.3%) complications: 1 (0.7%) minor stroke and 1 (0.7%) subarachnoid hemorrhage. There were 4 (3.2%) periprocedural embolic complications in the unprotected group versus 1 (0.7%) in the protected patients. CONCLUSIONS: Our data suggest that percutaneous dilation and stenting of the carotid arteries protected by cerebral protection devices is feasible and effective. In a consecutive series, the use of the cerebral protection systems reduced the acute neurological event rate related to embolic complications by 79%.
PURPOSE: To evaluate the impact of cerebral protection devices on the procedural safety and outcome of carotid stent procedures. METHODS: From June 1997 to July 2001, 275 consecutive patients (208 men; mean age 71 +/- 7.4 years) underwent percutaneous angioplasty and/or stenting of the extracranial carotid artery. In the first 125 (45.4%) patients, the procedures were performed without cerebral protection. After January 2000, protection devices were routinely used (150 [54.6%] patients), including the Angioguard filter, GuardWire occlusion system, TRAP Vascular Filtration System, EPI Filter Wire, NeuroShield, Parodi Anti-Embolism System, and Medicorp occlusive balloon. RESULTS: The percutaneous procedures were effective in 273 (99.3%) patients. No death or major stroke occurred in either group. In the unprotected group, 5 (4.0%) complications occurred: 3 (2.4%) minor strokes, 1 (0.8%) transient ischemic attack (TIA), and 1 (0.8%) subarachnoid hemorrhage. In the patients treated under cerebral protection, there were 2 (1.3%) complications: 1 (0.7%) minor stroke and 1 (0.7%) subarachnoid hemorrhage. There were 4 (3.2%) periprocedural embolic complications in the unprotected group versus 1 (0.7%) in the protected patients. CONCLUSIONS: Our data suggest that percutaneous dilation and stenting of the carotid arteries protected by cerebral protection devices is feasible and effective. In a consecutive series, the use of the cerebral protection systems reduced the acute neurological event rate related to embolic complications by 79%.
Authors: John D Barr; John J Connors; David Sacks; Joan C Wojak; Gary J Becker; John F Cardella; Bohdan Chopko; Jacques E Dion; Allan J Fox; Randall T Higashida; Robert W Hurst; Curtis A Lewis; Terence A S Matalon; Gary M Nesbit; J Arliss Pollock; Eric J Russell; David J Seidenwurm; Robert C Wallace Journal: AJNR Am J Neuroradiol Date: 2003 Nov-Dec Impact factor: 3.825
Authors: Benjamin Stoner-Duncan; Sae Jin Kim; Joanna L Mergeche; Zirka H Anastasian; Eric J Heyer Journal: J Neurosurg Anesthesiol Date: 2011-07 Impact factor: 3.956
Authors: G Simonetti; R Gandini; F Versaci; E Pampana; S Fabiano; M Stefanini; A Spinelli; C A Reale; M Di Primio; E Gaspari Journal: Radiol Med Date: 2008-09-26 Impact factor: 3.469
Authors: M Maynar; S Baldi; R Rostagno; T Zander; M Rabellino; R Llorens; J Alvarez; F Barajas Journal: AJNR Am J Neuroradiol Date: 2007-08 Impact factor: 3.825