Carotid artery stenting: utility of cerebral protection devices.
Neurologic deficits secondary to embolic events have been the most significant concern regarding carotid bifurcation stenting. Experimental studies utilizing human carotid plaques have shown that embolic particles were released from all specimens. In addition, transcranial Doppler studies have confirmed the fact that multiple emboli are released during each case. Preliminary experiences with the use of cerebral protection devices for carotid stenting have shown encouraging results with embolic particles recovered from each case, although these experiences have also revealed some of the down sides of its use. The present article provides the rationale for routine use of these protection devices and also reviews various protection devices, some of which are currently undergoing clinical trials.
Ohki
T
T
Endovascular Program, Assistant Professor of Surgery, Division of Vascular Surgery, Montefiore Medical Center, 111 East 210th Street, New York, NY 10467, USA. TAKOHKI@msn.com
Veith
F J
FJ
D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D016893:Carotid Stenosis / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D002533:Cerebral Angiography; D002560:Cerebrovascular Circulation; D006801:Humans; D011474:Prosthesis Design; D015607:Stents / Q000706:statistics & numerical data*; D020521:Stroke / Q000175:diagnosis / Q000503:physiopathology / Q000517:prevention & control*; D017585:Ultrasonography, Doppler, Transcranial