In vitro evaluation of the effectiveness of distal protection in the prevention of cerebral thromboembolism during carotid stent placement.
OBJECTIVE
The purpose of this in vitro study was to evaluate and quantify the benefit of the balloon protection device, to identify the most effective sequence of irrigation or flushing, and to determine the most effective catheter position to remove the maximum number of emboli or debris beneath the flow-arrest balloon.


METHODS
Silicone models of the neurovasculature were attached to a systodiastolic pump. Stents were placed in carotid stenoses by using the distal flow protection technique. Embolic material was released within the stent. The effectiveness of different irrigation techniques was evaluated.


RESULTS
Aspiration under the balloon through the guiding catheter with a 60-mL syringe followed by one power injection at 40 mL injected at 2 mL/sec will result in removal of about 98% of potential emboli from the internal carotid artery [corrected].


CONCLUSIONS
In vitro evaluation of the distal flow protection technique indicates that it should reduce stroke risk during carotid stent placement.
Martin
J B
JB
Department of Radiology, University Hospital of Geneva, Switzerland.
Murphy
K J
KJ
Gailloud
P
P
Sugiu
K
K
Treggiari
M M
MM
Muster
M
M
Guimaraens
L
L
Théron
J G
JG
Rüfenacht
D A
DA
D016893:Carotid Stenosis / Q000601:surgery*; D002404:Catheterization; D020766:Intracranial Embolism / Q000517:prevention & control*; D007431:Intraoperative Complications / Q000517:prevention & control*; D008955:Models, Cardiovascular; D015607:Stents