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Clinical Analysis Comparing Efficacy between a Distal Filter Protection Device and Proximal Balloon Occlusion Device during Carotid Artery Stenting
Journal of Korean Neurosurgical Society ; : 316-320, 2015.
Artículo en Inglés | WPRIM | ID: wpr-168893
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.
Asunto(s)

Texto completo: Disponible Índice: WPRIM (Pacífico Occidental) Asunto principal: Imagen por Resonancia Magnética / Arterias Carótidas / Stents / Infarto Cerebral / Estenosis Carotídea / Constricción Patológica / Embolia Intracraneal / Oclusión con Balón / Embolia / Dispositivos de Protección Embólica Límite: Humanos Idioma: Inglés Revista: Journal of Korean Neurosurgical Society Año: 2015 Tipo del documento: Artículo

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Texto completo: Disponible Índice: WPRIM (Pacífico Occidental) Asunto principal: Imagen por Resonancia Magnética / Arterias Carótidas / Stents / Infarto Cerebral / Estenosis Carotídea / Constricción Patológica / Embolia Intracraneal / Oclusión con Balón / Embolia / Dispositivos de Protección Embólica Límite: Humanos Idioma: Inglés Revista: Journal of Korean Neurosurgical Society Año: 2015 Tipo del documento: Artículo