CaRotid Artery Filtering Technique (CRAFT): A Technique for Carotid Artery Stenting with Intrinsic Embolic Protection.

Autor: Foo M; Department of Radiology, Austin Hospital, Melbourne, Vic, Australia., Ren Y; Department of Radiology, Austin Hospital, Melbourne, Vic, Australia., Gajera J; Department of Radiology, Alfred Health, Melbourne, Vic, Australia., Barras CD; South Australian Health and Medical Research Institute, University of Adelaide, Adelaide, SA, Australia.; Department of Radiology, Royal Adelaide Hospital, Adelaide, SA, Australia., Kok HK; Interventional Radiology Service, Department of Radiology, Northern Health, Melbourne, Vic, Australia.; School of Medicine, Faculty of Health, Deakin University, Waurn Ponds, Vic, Australia., Jhamb A; Interventional Radiology Service, Department of Radiology, St Vincent's Hospital, Melbourne, Vic, Australia., Abbouchie H; Department of Radiology, Austin Hospital, Melbourne, Vic, Australia., Maingard J; School of Medicine, Faculty of Health, Deakin University, Waurn Ponds, Vic, Australia.; Interventional Neuroradiology Service, Department of Radiology, Monash Health, Melbourne, Vic, Australia., Brooks DM; Department of Radiology, Austin Hospital, Melbourne, Vic, Australia.; Stroke Theme, The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Vic, Australia., Asadi H; Department of Radiology, Austin Hospital, Melbourne, Vic, Australia.; School of Medicine, Faculty of Health, Deakin University, Waurn Ponds, Vic, Australia.; Interventional Radiology Service, Department of Radiology, St Vincent's Hospital, Melbourne, Vic, Australia.; Interventional Neuroradiology Service, Department of Radiology, Monash Health, Melbourne, Vic, Australia.; Stroke Theme, The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Vic, Australia.
Jazyk: angličtina
Zdroj: Neurointervention [Neurointervention] 2021 Nov; Vol. 16 (3), pp. 260-266. Date of Electronic Publication: 2021 Oct 25.
DOI: 10.5469/neuroint.2021.00353
Abstrakt: Purpose: Carotid artery stenting (CAS) is an established treatment for symptomatic carotid artery stenosis as an alternative to carotid endarterectomy. A variety of techniques and devices have been devised to minimise periprocedural stroke risk using either proximal or distal embolic protection. This study presents a method of embolic protection during CAS-the CaRotid Artery Filtering Technique (CRAFT).
Materials and Methods: The CRAFT technique employs aspects of both proximal and distal embolic protection. The CASPER RX stent (MicroVention, Tustin, CA, USA), which is a double-layered, closed-cell, micromesh nitinol stent, is deployed across the carotid artery stenosis with the assistance of a FlowGate balloon guide catheter (Stryker Neurovascular, Fremont, CA, USA). The partially deployed stent acts as a distal filter while the balloon guide is deflated midway during stent deployment to prevent distal plaque embolisation, followed by completion of stent deployment and angioplasty.
Results: A total of 94 patients underwent CAS using the CRAFT technique between June 2016 and March 2021. Successful stent deployment was achieved in all patients. Preliminary results demonstrated acute stent occlusion in 6 patients (6.4%) and distal embolic stroke in 5 patients (5.3%). The median procedural fluoroscopy time was 34 minutes with an interquartile range of 22 to 55 minutes.
Conclusion: The CRAFT technique of CAS presented by this study can be applied in the treatment of symptomatic carotid artery stenosis in both emergency and elective procedure settings with a high technical success and low distal embolic stroke risk.
Databáze: MEDLINE
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