scholarly journals Evaluation of Carotid Artery Stenting with Distal Filter Protection Device

2018 ◽  
Vol 4 (02) ◽  
pp. 057-064
Author(s):  
Pankaj Banode ◽  
Ashutosh Kharche
Keyword(s):  
Predictive Value ◽  
Carotid Stenting ◽  
Minor Stroke ◽  
Technical Success ◽  
Embolic Protection ◽  
Closed Cell ◽  
First Choice ◽  
Proximal Protection ◽  
Protection Devices ◽  
Distal Filter

Abstract Objectives To assess the use of proximal protection devices in consecutive patients as the preferred means of cerebral embolic protection for primary carotid stenting. Methods and Results This was a prospective single-center study to evaluate the technical and clinical success of proximal protection devices as the first choice for embolic protection in symptomatic (≥ 50%) and asymptomatic (≥ 70%) carotid stenosis. Proximal protection devices were used for embolic protection in 115 consecutive patients. No patients were excluded for anatomical reasons. The filter used was of diameters 6 mm in all cases (Emboshield NAV filter device, Abbotts Healthcare Pvt. Ltd. [Lake Bluff, Il]). In all cases, self-expanding closed-cell designed stent was used (X-act closed-cell self-expanding nitinol carotid-tapered stent, Abbotts Healthcare Pvt. Ltd.). Plaque characterization was done by using real-time high-resolution ultrasound (HR USG) equipment (Aloka Prosound Alpha 7 [Chiyoda, Tokyo, Japan]) using high-frequency linear transducers (> 7 MHz). Follow-up duration was 30 days. Mean age was 61.9 ± 8.27 years. There was male predominance observed in study accounting for 73 out of total 115 studied population. Fifty-six of 115 (48.89%) treated stenoses were symptomatic. Technical success was achieved in 115 of 115 (100%) cases. In both the cases, additional distal filter devices were used. Carotid stenting was successful in 115 (100%) lesions. This study observed higher number of debris in symptomatic and high-risk plaques. This study also observed higher sensitivity, specificity, and accuracy of updated classification for assessing risk of microembolism (captured debris) (sensitivity 73.91%, specificity 95.65%, positive predictive value [PPV] 91.89%, negative predictive value [NPV] 84.62%, accuracy 86.95%). In our study, minor stroke was seen in three (2.61%) patients within 48 hours, and no adverse events were seen within 48 hours to 1 month. Conclusion Proximal protection is a safe method as the first choice for embolic protection. It can be used with a high rate of technical success.

scholarly journals Safety Outcomes Using a Proximal Protection Device in Carotid Stenting of Long Carotid Stenoses

2016 ◽  
Vol 5 (3-4) ◽  
pp. 123-130 ◽  
Author(s):  
Kunakorn Atchaneeyasakul ◽  
Priyank Khandelwal ◽  
Sudheer Ambekar ◽  
Kevin Ramdas ◽  
Luis Guada ◽  
...  
Keyword(s):  
Carotid Stenting ◽  
Minor Stroke ◽  
Lesion Length ◽  
Protection Device ◽  
Stroke Event ◽  
Embolic Protection ◽  
String Sign ◽  
Proximal Protection ◽  
Protection Devices ◽  
Major Stroke

Background: Embolic protection devices can prevent atherosclerotic emboli during carotid stenting. Newer proximal protection devices reverse flow in the internal carotid artery (ICA), leading to reduction in perioperative microemboli. The risk of stroke is high for carotid stenting of ICA lesions with a length >10 mm and/or angiographic string sign. Objective: We aimed to evaluate the safety outcomes of proximal embolic protection device usage in this high-risk group. Methods: This is a retrospective analysis of patients who underwent carotid stenting procedures with proximal embolic protection devices at a tertiary care center. High-risk features for adverse events with carotid stenting were identified. Peri- and postprocedural outcomes were recorded. We further compared outcomes in patients with a carotid stenosis length >10 mm to those with shorter stenosis. Results: From January 2011 to December 2014, we included 27 patients; 96.3% were symptomatic and 3.7% were asymptomatic. There was a stent placement technical success rate of 100%. No major stroke or coronary events were recorded. One minor stroke event developed in one patient. A carotid lesion length >10 mm and/or angiographic string sign was noted in 21/27 patients, with an average lesion length of 14.4 mm. One patient (4.8%) in this group developed a minor stroke event. Neither a coronary nor a major stroke event was recorded in this group. There was no significant difference in the complication rate between the long lesion and the control group. Conclusion: In our patient cohort, it was found that a proximal embolic protection device is safe for patients with carotid stenosis, including those with a carotid lesion length >10 mm and/or angiographic string sign.

Evaluation of proximal protection devices during carotid artery stenting as the first choice for embolic protection

2015 ◽  
Vol 10 (11) ◽  
pp. 1362-1367 ◽  
Author(s):  
Marius Hornung ◽  
Stefan C. Bertog ◽  
Jennifer Franke ◽  
Dani Id ◽  
Iris Grunwald ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Embolic Protection ◽  
First Choice ◽  
Proximal Protection ◽  
Protection Devices

scholarly journals The Use of Embolic Protection Devices Is Associated With a Lower Stroke and Death Rate After Carotid Stenting

2017 ◽  
Vol 10 (12) ◽  
pp. 1257-1265 ◽  
Author(s):  
Christoph Knappich ◽  
Andreas Kuehnl ◽  
Pavlos Tsantilas ◽  
Sofie Schmid ◽  
Thorben Breitkreuz ◽  
...  
Keyword(s):  
Death Rate ◽  
Carotid Stenting ◽  
Embolic Protection ◽  
Protection Devices

Embolic protection devices during carotid artery stenting: Is there a difference between proximal occlusion and distal filter?

2015 ◽  
Vol 187 ◽  
pp. 592-593 ◽  
Author(s):  
Giuseppe Gargiulo ◽  
Eugenio Stabile ◽  
Anna Sannino ◽  
Cinzia Perrino ◽  
Bruno Trimarco ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Embolic Protection ◽  
Protection Devices ◽  
Proximal Occlusion ◽  
Distal Filter

The role of embolic protection devices during carotid stenting prior to cardiac surgery in asymptomatic patients: Empty filters?

2012 ◽  
Vol 80 (1) ◽  
pp. 112-119 ◽  
Author(s):  
Jan Van der Heyden ◽  
Frank J. Wolters ◽  
Nathalie Garin ◽  
Snezana Andrejevic Blant ◽  
Marc Inglin ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Carotid Stenting ◽  
Embolic Protection ◽  
Asymptomatic Patients ◽  
Protection Devices

scholarly journals Carotid Stenting with the Use of Wallstent

2000 ◽  
Vol 6 (1_suppl) ◽  
pp. 181-185
Author(s):  
A. Ishii ◽  
K. Mitsudo ◽  
K. Kikuta ◽  
Y. Arakawa ◽  
M. Hojo ◽  
...  
Keyword(s):  
Carotid Stenting ◽  
Neurological Deficits ◽  
Treatment Modalities ◽  
Minor Stroke ◽  
Technical Success ◽  
Term Result ◽  
Residual Stenosis ◽  
Long Term Result ◽  
The Mean

We performed carotid stenting with Wallstent for 22 cases. The mean stenosis was 74.3 ± 11.2% before stenting and 14.2 ± 8.8% after stenting. The technical success (<40% residual stenosis) was 100%. We experienced 2 embolic complications (one TIA and one minor stroke). Permanent neurological deficits were not encountered in all the patients (0%). Restenosis was observed in 2 cases (12.5%). The both lesions revealed intimal hyperplasia on intravascular ultrasound (IVUS). MRI diffusion weighted study showed that distal embolism happened more often (46.2%) than we expected although most of them were asymptomatic. We must wait for the long term result to conclude that carotid stenting has become one of the treatment modalities.

scholarly journals TCT CONNECT-368 Embolic Protection Devices in Carotid Stenting: To Go Proximal or To Go Distal, That Is the Question

2020 ◽  
Vol 76 (17) ◽  
pp. B158-B159
Author(s):  
José Sousa ◽  
Luís Puga ◽  
Luís Paiva ◽  
Joana Silva ◽  
Marco Costa ◽  
...  
Keyword(s):  
Carotid Stenting ◽  
Embolic Protection ◽  
Protection Devices
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