Clinical Analysis Comparing Efficacy between a Distal Filter Protection Device and Proximal Balloon Occlusion Device during Carotid Artery Stenting.
10.3340/jkns.2015.58.4.316
- Author:
Jong Hyeok LEE
1
;
Hee Eon SOHN
;
Seung Young CHUNG
;
Moon Sun PARK
;
Seong Min KIM
;
Do Sung LEE
Author Information
1. Department of Neurosurgery, Eulji University Hospital, College of Medicine, Eulji University, Daejeon, Korea. neurocsy@eulji.ac.kr
- Publication Type:Original Article
- Keywords:
Carotid stenosis;
Diffusion magnetic resonance;
Embolic protection device;
Cerebral infarction
- MeSH:
Balloon Occlusion*;
Carotid Arteries*;
Carotid Stenosis;
Cerebral Infarction;
Constriction, Pathologic;
Embolic Protection Devices;
Embolism;
Humans;
Infarction;
Intracranial Embolism;
Magnetic Resonance Imaging;
Stents*
- From:Journal of Korean Neurosurgical Society
2015;58(4):316-320
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: The main concern during transfemoral carotid artery stenting (CAS) is preventing cerebral embolus dislodgement. We compared clinical outcomes and intraprocedural embolization rates of CAS using a distal filter protection device or proximal balloon occlusion device. METHODS: From January 2011 to March 2015, a series of 58 patients with symptomatic or asymptomatic internal carotid artery stenosis > or =70% were treated with CAS with embolic protection device in single center. All patients underwent post-CAS diffusion-weighted magnetic resonance imaging (DW-MRI) to detect new ischemic lesions. We compared clinical outcomes and postprocedural embolization rates. RESULTS: CAS was performed in all 61 patients. Distal filter protection success rate was 96.6% (28/29), whose mean age was 70.9 years, and mean stenosis was 81%. Their preprocedural infarction rate was 39% (11/28). Subsequent DW-MRI revealed 96 new ischemic lesions in 71% (20/28) patients. In contrast, the proximal balloon occlusion device success rate was 93.8% (30/32), whose mean age was 68.8 years and mean stenosis was 86%. Preprocedure infarction rate was 47% (14/30). DW-MRI revealed 45 new ischemic lesions in 57% (17/30) patients. Compared with distal filter protection device, proximal balloon occlusion device resulted in fewer ischemic lesions per patient (p=0.028). In each group, type of stent during CAS had no significant effect on number of periprocedural embolisms. Only 2 neurologic events occurred in the successfully treated patients (one from each group). CONCLUSION: Transfemoral CAS with proximal balloon occlusion device achieves good results. Compared with distal filter protection, proximal balloon occlusion might be more effective in reducing cerebral embolism during CAS.
