BACKGROUND AND PURPOSE: The routine use of distal filter devices during carotid angioplasty and stent placement (CAS) is controversial. The aim of this study was to analyze their effects on the incidence of new diffusion-weighted imaging (DWI) lesions as surrogate markers for stroke in important subgroups. MATERIALS AND METHODS: DWI was performed immediately before and after CAS in 68 patients with and 175 without protection, and patients were further subdivided according to their age or symptom status. RESULTS: The proportion of patients with new ipsilateral DWI lesion(s) was significantly lower after protected versus unprotected CAS (52% versus 68%), as well as in symptomatic patients (56% versus 74%) or those at or younger than 75 years of age (46% versus 67%; all P < .05). Similarly, the total number of lesions was significantly lower after protected versus unprotected CAS (median, 1; interquartile range [IQR], 0-2; versus median, 1; IQR 0-4.75) and in symptomatic patients (median, 1; IQR, 0-3; versus median, 2; IQR, 0-6) or those at or younger than 75 years of age (median, 0; IQR, 0-2; versus median, 1; IQR, 0-4; all P < .05). In contrast, for asymptomatic patients (48% versus 52%; P = .8; median, 0; IQR, 0-2; versus median, 1; IQR, 0-2.5; P = .6) or those older than 75 years of age (73% versus 69%; P = .7; median, 1; IQR, 0-4; versus median, 1.5; IQR, 0-5.75; P = .6), the proportion of patients with new lesion(s) and the total number of these lesions were not significantly different between protected and unprotected CAS. CONCLUSIONS: The use of distal filter devices generally reduces the incidence of new DWI lesions; however, this beneficial effect might not necessarily pertain to older and asymptomatic patients.
BACKGROUND AND PURPOSE: The routine use of distal filter devices during carotid angioplasty and stent placement (CAS) is controversial. The aim of this study was to analyze their effects on the incidence of new diffusion-weighted imaging (DWI) lesions as surrogate markers for stroke in important subgroups. MATERIALS AND METHODS: DWI was performed immediately before and after CAS in 68 patients with and 175 without protection, and patients were further subdivided according to their age or symptom status. RESULTS: The proportion of patients with new ipsilateral DWI lesion(s) was significantly lower after protected versus unprotected CAS (52% versus 68%), as well as in symptomatic patients (56% versus 74%) or those at or younger than 75 years of age (46% versus 67%; all P < .05). Similarly, the total number of lesions was significantly lower after protected versus unprotected CAS (median, 1; interquartile range [IQR], 0-2; versus median, 1; IQR 0-4.75) and in symptomatic patients (median, 1; IQR, 0-3; versus median, 2; IQR, 0-6) or those at or younger than 75 years of age (median, 0; IQR, 0-2; versus median, 1; IQR, 0-4; all P < .05). In contrast, for asymptomatic patients (48% versus 52%; P = .8; median, 0; IQR, 0-2; versus median, 1; IQR, 0-2.5; P = .6) or those older than 75 years of age (73% versus 69%; P = .7; median, 1; IQR, 0-4; versus median, 1.5; IQR, 0-5.75; P = .6), the proportion of patients with new lesion(s) and the total number of these lesions were not significantly different between protected and unprotected CAS. CONCLUSIONS: The use of distal filter devices generally reduces the incidence of new DWI lesions; however, this beneficial effect might not necessarily pertain to older and asymptomatic patients.
Authors: J Biller; W M Feinberg; J E Castaldo; A D Whittemore; R E Harbaugh; R J Dempsey; L R Caplan; T F Kresowik; D B Matchar; J f Toole; J D Easton; H P Adams; L M Brass; R W Hobson; T G Brott; L Sternau Journal: Stroke Date: 1998-02 Impact factor: 7.914
Authors: G S Roubin; G New; S S Iyer; J J Vitek; N Al-Mubarak; M W Liu; J Yadav; C Gomez; R E Kuntz Journal: Circulation Date: 2001-01-30 Impact factor: 29.690
Authors: G Maleux; P Demaerel; E Verbeken; K Daenens; S Heye; F Van Sonhoven; A Nevelsteen; G Wilms Journal: AJNR Am J Neuroradiol Date: 2006-10 Impact factor: 3.825
Authors: Luigi Giusto Spagnoli; Alessandro Mauriello; Giuseppe Sangiorgi; Stefano Fratoni; Elena Bonanno; Robert S Schwartz; David G Piepgras; Raimondo Pistolese; Arnaldo Ippoliti; David R Holmes Journal: JAMA Date: 2004-10-20 Impact factor: 56.272
Authors: Stephen F Stanziale; Luke K Marone; Tamer N Boules; Judith A Brimmeier; Katherine Hill; Michel S Makaroun; Mark H Wholey Journal: J Vasc Surg Date: 2006-02 Impact factor: 4.268
Authors: D Stojanov; M Ilic; P Bosnjakovic; M Zivkovic; S Jolic; N Vukasinovic; A Ignjatovic; B Ilic; D Benedeto-Stojanov Journal: AJNR Am J Neuroradiol Date: 2011-12-22 Impact factor: 3.825
Authors: Katrin Wasser; Helmut Hildebrandt; Sonja Gröschel; Tomislav Stojanovic; Holger Schmidt; Klaus Gröschel; Sara M Pilgram-Pastor; Michael Knauth; Andreas Kastrup Journal: J Neurol Date: 2012-04-19 Impact factor: 4.849