Routine use of cerebral protection [filter wire] during carotid artery stenting: results of a single center registry of 37 patients

ABSTRACT

To evaluate the short-term outcome of patients who underwent carotid stenting with the routine use of cerebral protection devices. In our center, 36 successful carotid stenting procedures [of 38 at tempted] were performed in 37 patients [23 men; aged 66 +/- 7 years]. Cerebral protection involved distal filter devices [n = 36] of which 12 were Accunet and 24 were EZ filter wires. The protection devices were positioned successfully in 36 of the 38 attempted vessels. The 30-day incidence of stroke and neurological death was three. Neurological complications included one major stroke, and one minor stroke. There was also one [sudden cardiac death on the first day]. The proportion of stroke or death was two for symptomatic lesions and one for asymptomatic lesions, and two in patients aged < 80 years and one in those aged >/= 80 years. Protection device-related vascular complications included mild spasm, which occurred after three procedures [8%], none of which led to neurological symptoms. There were another four cardiogenic deaths in 30-day follow-up. In this uncontrolled study, routine cerebral protection during carotid artery stenting was technically feasible and clinically safe. The incidence of major neurological complications in this study was lower than in previous reports of carotid artery stenting without cerebral protection