title: The association of clinical variables and filter design with carotid artery stenting thirty-day outcome.
abstract: OBJECTIVE
  Patient and device selection are important for the success of carotid artery stenting (CAS). We hypothesize that distal protection filter (DPF) design characteristics that minimize blood flow resistance and maximize capture efficiency are associated with the absence of transient ischemic attack (TIA), stroke and neurologic-related death after 30 days.
  
  
  METHODS
  Records from 208 patients were reviewed retrospectively. Filter design characteristics were quantified previously in our laboratory. The association between risk factors and design characteristics with 30-day outcome was quantified using univariate analysis.
  
  
  RESULTS
  The 30-day all-cause stroke and death rate was 8.7% (asymptomatic: 7.7%, symptomatic: 10.6%). Five DPFs were used in the study: Accunet (41.3%), Angioguard (33.2%), FilterWire (24%), Emboshield (1%), and Spider (.5%). Diabetes (P = .04) and prior carotid endarterectomy (CEA, P = .03) were associated with adverse outcome. Prior stroke (P = .01) and prior CEA (P = .04) were significant for peri-procedural stroke. Design characteristics such as capture efficiency were associated with favorable outcomes.
  
  
  CONCLUSIONS
  Patients with prior CEA or stroke are more likely to have unfavorable CAS outcomes after 30 days. Filters with high capture efficiency may yield the best clinical results. Analysis of the effect of design characteristics on CAS outcome should aid the design of future devices.
authors.affiliation: Biomedical Engineering Department, Carnegie Mellon University, 1210 Hamburg Hall, 5000 Forbes Avenue, Pittsburgh, PA 15213, USA.
authors.forename: G M
authors.initials: GM
authors.lastname: Siewiorek
authors.forename: R T
authors.initials: RT
authors.lastname: Krafty
authors.forename: M H
authors.initials: MH
authors.lastname: Wholey
authors.forename: E A
authors.initials: EA
authors.lastname: Finol
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D002340:Carotid Artery Diseases / Q000601:surgery*; D057510:Endovascular Procedures / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D015607:Stents