Proximal protection with the Gore PAES can reduce DWI lesion size in high-grade stenosis during carotid stenting.

Grunwald, Iris Q. and Reith, Wolfgang and Kuhn, Anna Luisa and Balami, Joyce S. and Karp, Kerstin and Fassbender, Klaus and Walter, Silke and Papanagiotou, Panagiotis and Krick, Christoph (2014) Proximal protection with the Gore PAES can reduce DWI lesion size in high-grade stenosis during carotid stenting. EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology.

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Abstract

AIMS: The aim was to determine the incidence of new ischaemic lesions on diffusion-weighted MR imaging (DWI) in a non-randomised cohort of patients after protected and unprotected carotid artery stent placement using the Parodi Anti-Emboli System (PAES). METHODS AND RESULTS: A retrospective review was conducted on 269 patients who received DWI prior to, and 24-72 hours after, stent placement. All patients were enrolled in one centre. Forty patients stented with the PAES device were matched with 229 patients stented without protection (control group). New diffusion restriction on DWI was detected in 25.8% (PAES) versus 32.3% (control group); p=0.64. On average there were 0.7 lesions (PAES) versus 0.8 lesions (control group) per patient. The area of lesions was 1.7 (PAES) versus 5.6 mm2. In a subanalysis of patients (32 PAES, 148 non-protected) with >80% stenosis, the area of restricted diffusion was less when proximal protection was used (p<0.05). The number and area of DWI lesions did not differ on the contralateral, non-stented side. When the PAES system was used, patients were more likely not to have any lesion at all (p=0.028). CONCLUSIONS: In high-grade stenosis, the use of the Gore PAES device significantly reduced the area of new DWI lesions and patients were more likely not to have any new DWI lesion at all.

Item Type: Journal Article
Additional Information: Citation: Grunwald, I.Q., Reith, W., Kühn, A.L., Balami, J.S., Karp, K., Fassbender, K., Walter, S., Papanagiotou, P. and Krick, C. 2014. Proximal protection with the Gore PAES can reduce DWI lesion size in high-grade stenosis during carotid stenting. EuroIntervention, 10(2), pp. 271-276..
Faculty: Faculty of Medical Science
Depositing User: Mr I Walker
Date Deposited: 22 Oct 2015 13:05
Last Modified: 30 Jun 2017 10:23
URI: http://arro.anglia.ac.uk/id/eprint/580137

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