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

Hornung, Marius and Bertog, Stefan C. and Franke, Jennifer and Id, Dani and Grunwald, Iris Q. and Sievert, Horst (2015) Evaluation of proximal protection devices during carotid artery stenting as the first choice for embolic protection. EuroIntervention, 10 (11). pp. 1362-1367. ISSN 1969-6213

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Official URL: http://dx.doi.org/10.4244/EIJY14M07_10

Abstract

Aims: 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-centre 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 124 consecutive patients. No patients were excluded for anatomical reasons. The GORE® Flow Reversal System (W.L. Gore, Flagstaff, AZ, USA) was used in 92 patients, and the Mo.Ma Ultra device (Medtronic, Minneapolis, MN, USA) in 32 patients. Follow-up duration was 30 days. Mean age was 71±8 years. Seventy-five percent of patients were male (n=93). Twenty-six of 124 (21%) treated stenoses were symptomatic. Technical success was achieved in 122 of 124 cases (98%). Due to anatomical conditions, in two patients flow reversal could not be established. In both cases additional distal filter devices were used. Carotid stenting was successful in 124 lesions (100%). Ten patients (8.1%) had contraindications to flow reversal (three high-grade ostial stenoses of the external carotid artery, seven contralateral occlusions of the internal carotid artery) in none of whom complications occurred. There were no procedural neurologic events. Within 30 days of follow-up, one patient had an ischaemic stroke (on day 11). Conclusions: Proximal protection is a safe method as the first choice for embolic protection. It can be used with a high rate of technical success.

Item Type: Journal Article
Keywords: carotid artery stenting, flow reversal, proximal occlusion
Faculty: ARCHIVED Faculty of Medical Science (until September 2018)
Depositing User: Repository Admin
Date Deposited: 22 Oct 2015 11:57
Last Modified: 05 Dec 2019 12:08
URI: http://arro.anglia.ac.uk/id/eprint/580117

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