Initial experience of using the filter protection device during carotid artery stenting in Japan.
OBJECTIVE
No filter protection devices for carotid artery stenting (CAS) have been formally approved for use in Japan; however, as of April 2008, the Angioguard XP (AGXP) was approved. This article describes our initial results using the AGXP during CAS for the treatment of carotid artery stenosis.


METHODS
A group of 15 patients (14 men) with a mean age of 72.3 years (range 53-81 years) were treated by CAS using the AGXP. Among them, 10 were symptomatic with >50% stenosis of the common or internal carotid artery (ICA), and 5 were asymptomatic with >70% stenosis. The rates of technical success, periprocedural stroke, ICA flow impairment, filter movement, and development of new ischemic lesions on diffusion-weighted imaging (DWI) were assessed.


RESULTS
CAS using the AGXP was successful in all cases. There was one minor stroke, and flow impairment occurred in six patients. Filter movement averaged 1.9 vertebral bodies. DWI showed new ipsilateral ischemic lesions in eight of the patients.


CONCLUSIONS
Initial clinical experience using the AGXP for CAS has been generally sufficient. However, attention must be paid to three problems when using the AGXP: the filter may move after placement; the filter may disturb blood flow in the ICA; and debris may pass around the filter.
Takayama
Katsutoshi
K
Department of Interventional Neuroradiology, Ishinkai Yao General Hospital, 1-41 Numa, Yao 581-0036, Japan, takayamaneuroivs@par.odn.ne.jp
Nakagawa
Hiroyuki
H
Iwasaki
Satoru
S
Taoka
Toshiaki
T
Miyasaka
Toshiteru
T
Myouchin
Kaoru
K
Wada
Takeshi
T
Sakamoto
Masahiko
M
Fukusumi
Akio
A
Nakagawa
Ichiro
I
Kurokawa
Shinichiro
S
Kichikawa
Kimihiko
K
D000368:Aged; D000369:Aged, 80 and over; D016893:Carotid Stenosis / Q000628:therapy*; D005260:Female; D005374:Filtration / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents