title: Comparing the embolic potential of open and closed cell stents during carotid angioplasty and stenting.
abstract: OBJECTIVE
  We sought to determine the effects of open (O) and closed (C) cell stents on the size and number of embolic particles generated during carotid artery stenting (CAS) and assess the impact on outcome.
  
  
  METHODS
  Embolic debris from carotid filters after CAS was analyzed using photomicroscopy and imaging software. Patient comorbidities, preoperative cerebrovascular symptoms, stent type, and outcomes (perioperative major adverse events) were examined.
  
  
  RESULTS
  Carotid filters from 173 consecutive CAS procedures (O, 125 and C, 48) were reviewed. The mean age was 70.9 ± 9.2 years; 58% were men. Mean stenosis was 88.2% ± 8.1%; 36.6% had neurological symptoms preprocedurally. There was no difference in preoperative symptoms between the two groups (O, 38.7% vs C, 31.3%; P = not significant [NS]). However, closed cell stent use was associated with higher degree of stenosis (O, 87.2% ± 8.0% vs C, 90.6% ± 7.8%; P = .01), an older age (O, 70.0 ± 8.6 years vs C, 73.4 ± 10.2 years; P = .03), and peripheral arterial disease (21.1% vs 43.5%; P = .01). A larger mean particle size was observed in patients treated with open cell stents compared to closed cell stents (O, 416.5 ± 335.7 μm vs C, 301.1 ± 251.3 μm; P = .03). There was no significant difference in the total number of particles (O, 13.8 ± 21.5 vs C, 17.6 ± 19.9; P = NS), periprocedural stroke (P = NS), and major adverse events between the two groups (P = NS).
  
  
  CONCLUSIONS
  Open cell stents are associated with a larger mean particle size compared to closed cell stents. No impact on procedural outcomes based on stent type was observed.
authors.affiliation: Department of Vascular Surgery, Mount Sinai School of Medicine, New York, NY 10029, USA.
authors.forename: Rami O
authors.initials: RO
authors.lastname: Tadros
authors.forename: Constantinos T
authors.initials: CT
authors.lastname: Spyris
authors.forename: Ageliki G
authors.initials: AG
authors.lastname: Vouyouka
authors.forename: Christine
authors.initials: C
authors.lastname: Chung
authors.forename: Prakash
authors.initials: P
authors.lastname: Krishnan
authors.forename: Margaret W
authors.initials: MW
authors.lastname: Arnold
authors.forename: Michael L
authors.initials: ML
authors.lastname: Marin
authors.forename: Peter L
authors.initials: PL
authors.lastname: Faries
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty / Q000009:adverse effects / Q000379:methods*; D016893:Carotid Stenosis / Q000601:surgery*; D005260:Female; D006801:Humans; D020766:Intracranial Embolism / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D010316:Particle Size; D018579:Patient Selection; D011474:Prosthesis Design; D012307:Risk Factors; D015607:Stents / Q000009:adverse effects; D016896:Treatment Outcome