Impact of Cerebral Protection Devices on Early Outcome of Carotid Stenting

Autor: Fausto Castriota, Enrico Ricci, Kareem Oshola, Raffaella Manetti, Alberto Cremonesi, Guido Balestra, Armando Liso
Rok vydání: 2002
Předmět:
Male
Reoperation
medicine.medical_specialty
Time Factors
Subarachnoid hemorrhage
Percutaneous
Carotid Artery
Common
Vasodilator Agents
medicine.medical_treatment
Carotid arteries
030204 cardiovascular system & hematology
Balloon
030218 nuclear medicine & medical imaging
Percutaneous angioplasty
Blood Vessel Prosthesis Implantation
Nitroglycerin
03 medical and health sciences
0302 clinical medicine
Occlusion
medicine
Humans
Carotid Stenosis
Radiology
Nuclear Medicine and imaging
Device Removal
Aged
Neurologic Examination
business.industry
Protective Devices
Graft Occlusion
Vascular
Mean age
Middle Aged
Subarachnoid Hemorrhage
medicine.disease
Surgery
Stroke
Treatment Outcome
Italy
Ischemic Attack
Transient
Cerebrovascular Circulation
Female
Stents
Carotid stenting
Tomography
X-Ray Computed
Cardiology and Cardiovascular Medicine
business
Zdroj: Journal of Endovascular Therapy. 9:786-792
ISSN: 1545-1550
1526-6028
DOI: 10.1177/152660280200900611
Popis: 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%.
Databáze: OpenAIRE
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