INTRODUCTION: To evaluate the flow reversal efficacy of the Parodi antiembolism system (PAES) in the prevention of distal emboli during carotid stenting. METHODS: A total of 90 patients were treated for internal carotid artery (ICA) stenosis with a stent device. A PAES device was used in 31 symptomatic and 5 asymptomatic patients (total 36 patients) with ICA stenosis, and 54 patients were stented without any protection device. Diffusion-weighted (DW) imaging was performed before and after stenting. RESULTS: In the group without PAES protection, 23 out of 54 patients showed new lesions on DW images after stenting. Of the lesions seen, 147 (2.72 lesions/patient) were in the vessel-dependent area. In the group with protection, 19 out of 36 patients had new lesions, and only 34 (0.94 lesions/patient) were noted in the vessel-dependent area. The number of new lesions in the nondependent vessel area did not differ if a protection system was used (P = 0.671). The use of PAES led to a significant reduction (P = 0.024) in the incidence of the most frequently seen lesions (size <2 mm). The stroke death rate was 3.3% overall, 3.7% in the group without protection device, and 2.7% in the PAES group. There were no permanent neurological deficits after 3 months. CONCLUSION: The PAES is a safe and effective tool to reduce the incidence of embolic complications during carotid stenting. Older patients and patients with higher grade stenosis seem to profit more.
INTRODUCTION: To evaluate the flow reversal efficacy of the Parodi antiembolism system (PAES) in the prevention of distal emboli during carotid stenting. METHODS: A total of 90 patients were treated for internal carotid artery (ICA) stenosis with a stent device. A PAES device was used in 31 symptomatic and 5 asymptomatic patients (total 36 patients) with ICA stenosis, and 54 patients were stented without any protection device. Diffusion-weighted (DW) imaging was performed before and after stenting. RESULTS: In the group without PAES protection, 23 out of 54 patients showed new lesions on DW images after stenting. Of the lesions seen, 147 (2.72 lesions/patient) were in the vessel-dependent area. In the group with protection, 19 out of 36 patients had new lesions, and only 34 (0.94 lesions/patient) were noted in the vessel-dependent area. The number of new lesions in the nondependent vessel area did not differ if a protection system was used (P = 0.671). The use of PAES led to a significant reduction (P = 0.024) in the incidence of the most frequently seen lesions (size <2 mm). The stroke death rate was 3.3% overall, 3.7% in the group without protection device, and 2.7% in the PAES group. There were no permanent neurological deficits after 3 months. CONCLUSION: The PAES is a safe and effective tool to reduce the incidence of embolic complications during carotid stenting. Older patients and patients with higher grade stenosis seem to profit more.
Authors: J B Martin; J C Pache; M Treggiari-Venzi; K J Murphy; P Gailloud; E Puget; G Pizzolato; K Sugiu; L Guimaraens; J Théron; D A Rüfenacht Journal: Stroke Date: 2001-02 Impact factor: 7.914
Authors: J G Webb; R G Carere; R Virmani; D Baim; P S Teirstein; P Whitlow; C McQueen; F D Kolodgie; E Buller; A Dodek; G B Mancini; S Oesterle Journal: J Am Coll Cardiol Date: 1999-08 Impact factor: 24.094
Authors: I Q Grunwald; T Supprian; M Politi; T Struffert; P Falkai; C Krick; M Backens; W Reith Journal: Neuroradiology Date: 2006-04-07 Impact factor: 2.804
Authors: C C Phatouros; R T Higashida; A M Malek; P M Meyers; T E Lempert; C F Dowd; V V Halbach Journal: Radiology Date: 2000-10 Impact factor: 11.105
Authors: A Jacobs; M Neveling; M Horst; M Ghaemi; J Kessler; H Eichstaedt; J Rudolf; P Model; H Bönner; E R de Vivie; W D Heiss Journal: Stroke Date: 1998-03 Impact factor: 7.914