Flow-reversal device for cerebral protection during carotid artery stenting--acute and long-term results.
OBJECTIVE
Several types of cerebral (embolic) protection devices have been used in patients undergoing carotid stenting. This study assessed results achieved with a flow-reversal system.


METHODS
Carotid stenting was performed in 56 patients (mean age, 68 +/- 9 years). The mean percentage of stenosis was 77%+/- 10%. During the procedure, cerebral protection was achieved by means of balloon occlusion of the common and external carotid artery with use of a Parodi Anti-Emboli System. The patients' neurologic status was assessed during the intervention; at discharge; 1, 6, and 12 months after the procedure; and yearly thereafter.


RESULTS
The procedure was technically successful in all cases. One patient had a minor stroke 6 hours after the intervention. No major strokes, deaths, or myocardial infarctions occurred. During long-term follow-up (to 40 months), 2 patients died of a secondary complication after intracerebral bleeding and stroke and 1 died as a result of ventricular fibrillation. Restenosis did not exceed 50% of vessel diameter in any patient.


CONCLUSIONS
The acute results indicate that proximal occlusion and flow reversal for cerebral protection during carotid stenting is a safe and effective method. The low restenosis and complication rate during long-term follow-up is in accordance with other series of carotid angioplasty and shows that the occlusion balloons do not cause any long-term side effects.
CardioVascular Center Frankfurt, Frankfurt, Germany.
Kasja
K
Rabe
Jennifer
J
Sugita
Heike
H
Gödel
Horst
H
Sievert
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon; D019917:Blood Vessel Prosthesis Implantation; D002340:Carotid Artery Diseases / Q000503:physiopathology / Q000628:therapy*; D002540:Cerebral Cortex / Q000098:blood supply* / Q000503:physiopathology; D003251:Constriction, Pathologic / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D012039:Regional Blood Flow; D015607:Stents / Q000009:adverse effects*; D013997:Time Factors