title: Comparison of anti-embolic protection with proximal balloon occlusion and filter devices during carotid artery stenting: clinical and procedural outcomes.
abstract: OBJECTIVE
  The objective of this study was to compare the periprocedural and clinical outcomes after carotid artery stenting (CAS) with proximal protection devices versus with distal protection devices.
  
  
  METHODS
  Patients with internal carotid artery (ICA) stenosis undergoing CAS with cerebral embolic protection were randomly assigned to proximal balloon occlusion or distal filter protection. Adverse events were defined as death, major stroke, minor stroke, transient ischemic attack (TIA) and myocardial infarction (MI). Periprocedural and 30-day adverse events and ICA vasospasm rates were compared between the two embolic protection groups.
  
  
  RESULTS
  Eighty-eight consecutive patients were randomized: 48 patients with proximal protection (mean age 68.8 ±13.6, 66% male) and 40 patients with a distal protection device (mean age 65.4 ±12.3; 70% male). There was no significant difference in periprocedural or 30-day adverse event rates between the two groups (p > 0.05). However, there was a higher periprocedural ICA vasospasm rate in the distal filter protection group (9 patients, 23%) compared with the proximal balloon occlusion group (1 patient, 2%) (p = 0.019).
  
  
  CONCLUSIONS
  There was no difference between the clinical periprocedural and 30-day adverse event rates of distal filter and proximal balloon protection systems. However, distal filter protection systems showed higher rates of periprocedural ICA vasospasm.
authors.affiliation: Department of Cardiology, Ada TIp Hospital, Sakarya, Turkey.
authors.forename: Ersan
authors.initials: E
authors.lastname: Tatli
authors.affiliation: Department of Cardiology, Acibadem University Hospital, Istanbul, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Buturak
authors.affiliation: Department of Radiology, Sakarya University, School of Medicine, Sakarya, Turkey.
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Grunduz
authors.affiliation: Department of Cardiology, Ada TIp Hospital, Sakarya, Turkey.
authors.forename: Emir
authors.initials: E
authors.lastname: Dogan
authors.affiliation: Department of Cardiology, Ada TIp Hospital, Sakarya, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Alkan
authors.affiliation: Department of Neurosurgery, Ada TIp Hospital, Sakarya, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Sayin
authors.affiliation: Department of Cardiology, Ada TIp Hospital, Sakarya, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Yilmaztepe
authors.affiliation: Department of Neurosurgery, Ada TIp Hospital, Sakarya, Turkey.
authors.forename: Selcuk
authors.initials: S
authors.lastname: Atakay
keywords: carotid artery stenosis; protection devices; stenting