Immunohistochemical Analysis of Debris Captured by Filter-Type Distal Embolic Protection Devices for Carotid Artery Stenting
| Autor: | Yuichi Murayama, Takashi Umezawa, Masafumi Suzuki, Toshihiro Ishibashi, Hiroyuki Takao, Ichiro Yuki, Yukinao Kambayashi, Ayako Ikemura, Issei Kan |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Pathology Carotid arteries medicine.medical_treatment Antigens Differentiation Myelomonocytic 030204 cardiovascular system & hematology Embolic Protection Devices 03 medical and health sciences 0302 clinical medicine Antigens CD Cytology medicine Humans Carotid Stenosis 030212 general & internal medicine Stroke Aged business.industry Endovascular Procedures Rehabilitation Fibrous cap Middle Aged medicine.disease Fibrosis Immunohistochemistry Debris Actins Plaque Atherosclerotic Diffusion Magnetic Resonance Imaging medicine.anatomical_structure Female Surgery Neurology (clinical) Radiology Carotid stenting Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of Stroke and Cerebrovascular Diseases. 26:816-822 |
| ISSN: | 1052-3057 |
| DOI: | 10.1016/j.jstrokecerebrovasdis.2016.10.025 |
| Popis: | Background Little is known about the micro-debris captured in filter-type distal embolic protection devices (EPD) used for carotid stenting (CAS). This study aimed to determine the histological and immunohistochemical characteristics of such debris by using a new liquid-based cytology (LBC) technique. Methods Fifteen patients who underwent CAS using a filter-type distal EPD (FilterWire EZ; Boston Scientific, Marlborough, MA, USA) were included in the study. After gross inspection of each recovered filter device, micro-debris were collected using a new LBC technique (SurePath; TriPath Imaging, Inc., Burlington, NC). Histological and immunohistochemical analysis of the recovered debris was performed. The pre- and postoperative brain magnetic resonance imaging and neurological status of each patient were also reviewed. Results No patient developed ipsilateral symptomatic stroke due to a thromboembolic event. All 15 patients (100%) had microscopically identifiable debris in the filters, whereas gross inspection detected visible debris only in 5 patients (33.3%). Histological analysis revealed various types of structural components in an advanced atheromatous plaque, including fragments of fibrous cap, calcified plaque, smooth muscle cells, and necrotic tissue fragment infiltrated with monocytes and macrophages. Conclusions Filter-type EPDs may contribute to reducing the risk of CAS-related embolic events by capturing micro-debris even when gross inspection of the recovered filter shows no visible debris in the device. |
| Databáze: | OpenAIRE |
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