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 CRT-300.04 Comparison of Devices in Carotid Artery Stenting: A Vascular Quality Initiative Analysis of Commonly Used Carotid Stents and Embolic Protection Devices

2017 ◽  
Vol 10 (3) ◽  
pp. S41
Author(s):  
Ashwat S. Dhillon ◽  
Sisi Li ◽  
Juan Pablo Lewinger ◽  
Leonardo C. Clavijo ◽  
David M. Shavelle ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Embolic Protection ◽  
Protection Devices

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 Proximal embolic protection devices for high risk lesions/patients in "TARGET-CAS" registry of 1717 consecutive carotid artery stenting procedures

2013 ◽  
Vol 34 (suppl 1) ◽  
pp. 2597-2597
Author(s):  
L. Tekieli ◽  
P. Pieniazek ◽  
P. Musialek ◽  
T. Przewlocki ◽  
A. Kablak-Ziembicka ◽  
...  
Keyword(s):  
High Risk ◽  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Embolic Protection ◽  
Protection Devices ◽  
Cas Registry

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

Abstract 1122‐000174: Stroke Risk of Carotid Artery Stenting Using Balloon‐Guide Catheter Versus Distal Embolic Protection Devices

2021 ◽  
Vol 1 (S1) ◽  
Author(s):  
Michael I Nahhas ◽  
Grant J Meeks ◽  
Juan Carlos Martinez‐Gutierrez ◽  
Gary R Spiegel ◽  
Yazan Alderazi ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Focal Neurological Deficit ◽  
Embolic Protection ◽  
Guide Catheter ◽  
Primary Means ◽  
Protection Devices ◽  
Distal Protection ◽  
Proximal Occlusion

Introduction : Prevention of distal embolization during carotid artery stenting (CAS) is a key element of procedural technique and is standardly performed using distal protection devices (DPDs). Data in support of DPDs, however, are limited. Here, we present our experience of proximal occlusion using a balloon guide catheter (BGC) during CAS as the primary method of distal embolic protection. Methods : We conducted a retrospective review of patients undergoing CAS at our healthcare system between January of 2018 to March of 2021. Procedures were categorized by embolic protection strategy: DPD or BGC (with or without DPD). Emergent cases were defined as patients receiving CAS within <24 hours of presenting with an ischemic stroke or TIA ipsilateral to the carotid disease side. Severe stenosis was defined as 70–99% per NASCET criteria. The primary outcome was rate of procedural ischemic stroke between the DPD and BGC groups, and was defined as acute focal neurological deficit lasting for ≥ 24 hours following CAS related to an embolic event during the procedure. Results : A total of 126 CAS procedures were performed during the study period. 91 cases were performed under proximal BGC protection (of which 24 also included DPD usage) and 35 CAS cases via DPD as a primary mean for embolic protection. The median age for the cohort was 68 [IQR 62‐76], 37% females, 31% (n = 39) cases were treated emergently, and elective cases were 69% (n = 87). Baseline characteristics were similar in both groups except for hyperlipidemia (BGC vs DPD, 71.4% vs 42.9%; p = 0.003) and history of smoking (BGC vs DPD, 56% vs 34.4%; p = 0.029). Severe carotid stenosis was present in 80.2% BGC group and 77.1% in DPD (p = 0.573). Post‐stenting balloon angioplasty was more frequent in the BGC group as compared with DPD (54% vs. 26%, BGC vs. DPD, p = 0.005). Procedural embolic stroke rates were low in both groups, and not significantly different (1.1% vs. 2.9%, BGC vs. DPD, p = 0.48). Conclusions : CAS with BGC as the primary means of distal embolic protection showed comparable, low rates of procedural embolic ischemic events compared to those with DPD. These findings suggest BGC embolic strategies may be a viable alternative to DPD usage.

Limiting Complications During Carotid Artery Stenting in Complex Lesions

2010 ◽  
Vol 5 (1) ◽  
pp. 66
Author(s):  
Fabrizio Fanelli ◽  
Emanuele Boatta ◽  
Pierleone Lucatelli ◽  
Roberto Passariello ◽  
◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Plaque Morphology ◽  
Permanent Disability ◽  
The Us ◽  
Protection Systems ◽  
Proximal Protection ◽  
Protection Devices ◽  
Distal Occlusion ◽  
Selection Of

Stroke is the third leading cause of death and permanent disability in the US and Europe. During the last decade, carotid artery stenting (CAS) has gained a role as an alternative option to carotid endoarterectomy (CEA). Both patient selection and plaque morphology are crucial to reduce the risk of complications. Technical aspects such as the employment and selection of different types of cerebral protection devices, distal occlusion balloons, filters, proximal protection systems and stent selection will be widely discussed.

scholarly journals Comparison of Flow Impairment during Carotid Artery Stenting Using Two Types of Eccentric Filter Embolic Protection Devices

2016 ◽  
Vol 56 (12) ◽  
pp. 759-765 ◽  
Author(s):  
Kouhei NII ◽  
Masanori TSUTSUMI ◽  
Hitoshi MAEDA ◽  
Hiroshi AIKAWA ◽  
Ritsuro INOUE ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Embolic Protection ◽  
Protection Devices

Serial Changes of Circulating Platelet Activation Markers after Carotid Artery Stenting

Angiology ◽  
2008 ◽  
Vol 60 (4) ◽  
pp. 427-430 ◽  
Author(s):  
Fang Liu ◽  
Jin Li ◽  
Da-Ming Wang ◽  
Jia-Chun Liu ◽  
Yi-Ning Huang
Keyword(s):  
Flow Cytometry ◽  
Carotid Artery ◽  
Antiplatelet Therapy ◽  
Platelet Activation ◽  
Carotid Artery Stenting ◽  
Dual Antiplatelet Therapy ◽  
Activation Markers ◽  
Embolic Protection ◽  
Protection Devices ◽  
Platelet Aggregates

We investigated serial changes of circulation platelet activation markers in 40 patients undergoing carotid artery stenting under the protection of dual antiplatelet therapy and filter devices. Monocyte-platelet aggregates and PAC-1 (a marker specific for activated glycoprotein IIb/IIIa) analyzed by flow cytometry were determined in patients with symptomatic stenosis undergoing elective carotid artery stenting. Blood samples were obtained immediately before stent implantation and 0.5 hours, 18 hours, and 6 days after the procedure, respectively. All patients were already on dual antiplatelet therapy of aspirin and clopidogrel before carotid artery stenting, and all were stented with embolic protection devices. Both circulation monocyte-platelet aggregates and PAC-1 did not change significantly at the various time points after the procedure. Serial changes of monocyte-platelet aggregates and PAC-1 analyzed by flow cytometry fail to indicate the occurrence of platelet activation after carotid artery stenting under the treatment with dual antiplatelet therapy before carotid artery stenting and the application of embolic protection devices during the procedure.

Efficiency test of current carotid embolic protection devices

2017 ◽  
Vol 62 (4) ◽  
pp. 349-355 ◽  
Author(s):  
Anja Kurzhals ◽  
Jörn-Bo Matthies ◽  
Reimer Andresen ◽  
Christian Wissgott ◽  
Klaus-Peter Schmitz ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Capture Efficiency ◽  
Embolic Protection ◽  
Protection Devices ◽  
Efficiency Test

AbstractEmbolic protection devices were developed to reduce the risk of stroke during carotid artery stenting. The aim of this study was to test the capture efficiency of five embolic protection devices under reproducible

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