title: Impact of cerebral protection devices on early outcome of carotid stenting.
abstract: OBJECTIVE
  To evaluate the impact of cerebral protection devices on the procedural safety and outcome of carotid stent procedures.
  
  
  METHODS
  From June 1997 to July 2001, 275 consecutive patients (208 men; mean age 71 +/- 7.4 years) underwent percutaneous angioplasty and/or stenting of the extracranial carotid artery. In the first 125 (45.4%) patients, the procedures were performed without cerebral protection. After January 2000, protection devices were routinely used (150 [54.6%] patients), including the Angioguard filter, GuardWire occlusion system, TRAP Vascular Filtration System, EPI Filter Wire, NeuroShield, Parodi Anti-Embolism System, and Medicorp occlusive balloon.
  
  
  RESULTS
  The percutaneous procedures were effective in 273 (99.3%) patients. No death or major stroke occurred in either group. In the unprotected group, 5 (4.0%) complications occurred: 3 (2.4%) minor strokes, 1 (0.8%) transient ischemic attack (TIA), and 1 (0.8%) subarachnoid hemorrhage. In the patients treated under cerebral protection, there were 2 (1.3%) complications: 1 (0.7%) minor stroke and 1 (0.7%) subarachnoid hemorrhage. There were 4 (3.2%) periprocedural embolic complications in the unprotected group versus 1 (0.7%) in the protected patients.
  
  
  CONCLUSIONS
  Our data suggest that percutaneous dilation and stenting of the carotid arteries protected by cerebral protection devices is feasible and effective. In a consecutive series, the use of the cerebral protection systems reduced the acute neurological event rate related to embolic complications by 79%.
authors.affiliation: Interventional Cardio-Angiology Unit, Villa Maria Cecilia Hospital, Cotignola, Italy. vmc.emod@gruppovillamaria.it
authors.forename: Fausto
authors.initials: F
authors.lastname: Castriota
authors.forename: Alberto
authors.initials: A
authors.lastname: Cremonesi
authors.forename: Raffaella
authors.initials: R
authors.lastname: Manetti
authors.forename: Armando
authors.initials: A
authors.lastname: Liso
authors.forename: Kareem
authors.initials: K
authors.lastname: Oshola
authors.forename: Enrico
authors.initials: E
authors.lastname: Ricci
authors.forename: Guido
authors.initials: G
authors.lastname: Balestra
mesh_terms: D000368:Aged; D019917:Blood Vessel Prosthesis Implantation; D017536:Carotid Artery, Common / Q000601:surgery*; D016893:Carotid Stenosis / Q000150:complications / Q000601:surgery*; D002560:Cerebrovascular Circulation / Q000187:drug effects; D020878:Device Removal; D005260:Female; D006083:Graft Occlusion, Vascular / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D006801:Humans; D002546:Ischemic Attack, Transient / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D007558:Italy; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D005996:Nitroglycerin / Q000627:therapeutic use; D011482:Protective Devices; D012086:Reoperation; D015607:Stents; D020521:Stroke / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000627:therapeutic use
chemical_list: D014665:Vasodilator Agents; D005996:Nitroglycerin