title: Proximal protection with the Gore PAES can reduce DWI lesion size in high-grade stenosis during carotid stenting.
abstract: OBJECTIVE
  The aim was to determine the incidence of new ischaemic lesions on diffusion-weighted MR imaging (DWI) in a non-randomised cohort of patients after protected and unprotected carotid artery stent placement using the Parodi Anti-Emboli System (PAES).
  
  
  RESULTS
  A retrospective review was conducted on 269 patients who received DWI prior to, and 24-72 hours after, stent placement. All patients were enrolled in one centre. Forty patients stented with the PAES device were matched with 229 patients stented without protection (control group). New diffusion restriction on DWI was detected in 25.8% (PAES) versus 32.3% (control group); p=0.64. On average there were 0.7 lesions (PAES) versus 0.8 lesions (control group) per patient. The area of lesions was 1.7 (PAES) versus 5.6 mm2. In a subanalysis of patients (32 PAES, 148 non-protected) with >80% stenosis, the area of restricted diffusion was less when proximal protection was used (p<0.05). The number and area of DWI lesions did not differ on the contralateral, non-stented side. When the PAES system was used, patients were more likely not to have any lesion at all (p=0.028).
  
  
  CONCLUSIONS
  In high-grade stenosis, the use of the Gore PAES device significantly reduced the area of new DWI lesions and patients were more likely not to have any new DWI lesion at all.
authors: Postgraduatate Medical Institute (PMI), Anglia Ruskin University, Chelmsford, Essex, and Southend University Hospital, Essex, United Kingdom.
authors: Iris Quasar
authors: IQ
authors: Grunwald
authors: Wolfgang
authors: W
authors: Reith
authors: Anna Luisa
authors: AL
authors: Kühn
authors: Joyce S
authors: JS
authors: Balami
authors: Kerstin
authors: K
authors: Karp
authors: Klaus
authors: K
authors: Fassbender
authors: Silke
authors: S
authors: Walter
authors: Panagiotis
authors: P
authors: Papanagiotou
authors: Christoph
authors: C
authors: Krick
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty / Q000009:adverse effects / Q000295:instrumentation*; D002545:Brain Ischemia / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D016893:Carotid Stenosis / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D038524:Diffusion Magnetic Resonance Imaging; D057505:Embolic Protection Devices; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015607:Stents; D016896:Treatment Outcome