title: Comparison of dual protection and distal filter protection as a distal embolic protection method during carotid artery stenting: a single-center carotid artery stenting experience.
abstract: There are several protection methods used to prevent distal embolism during carotid artery stenting (CAS). The aim of this study was to compare the dual protection method (proximal balloon and distal filter protection) with the distal filter protection during CAS performed at a single center. Between April 2008 and November 2013, 78 consecutive patients with internal carotid artery stenosis were treated with CAS at Istukaichi Memorial Hospital. Twenty-four consecutive patients were treated with CAS using distal filter protection (distal filter protection group), and 54 consecutive patients were treated with CAS using dual protection with a proximal balloon and distal filter protection (dual protection group). We examined the hyperintensity lesions on diffusion-weighted imaging (DWI) and perioperative complications after CAS. All stenotic lesions were successfully dilated. DWI showed hyperintensity lesions among 54.2 % (13/24 patients) in the distal filter protection group and in 27.8 % (15/54 patients) in the dual protection group (p = 0.024). The average number of hyperintensity lesions on DWI was 1.75 (range, 0 to 6) in the distal filter protection group and 0.59 (range, 0 to 5) in the dual protection group (p = 0.0087). Postprocedural persistent ischemic complications occurred in 4.2 % (1/24 patients) in the distal filter protection group and 3.7 % (2/54 patients) in the dual protection group (p = 0.67). In this study, the dual protection method reduced the number of hyperintensity lesions seen on DWI when compared with the distal filter protection method when used for distal embolic protection during CAS.
authors.affiliation: Department of Neurosurgery, Itsukaichi Memorial Hospital, 1-95 Kurashige, Saeki-ku, Hiroshima, 731-5156, Japan, yosukekajihara@yahoo.co.jp.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Kajihara
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Sakamoto
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kiura
authors.forename: Kazutoshi
authors.initials: K
authors.lastname: Mukada
authors.forename: Takahiro
authors.initials: T
authors.lastname: Chaki
authors.forename: Shiro
authors.initials: S
authors.lastname: Kajihara
authors.forename: Kaoru
authors.initials: K
authors.lastname: Kurisu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D000800:Angioplasty, Balloon; D002545:Brain Ischemia / Q000473:pathology; D002339:Carotid Arteries / Q000601:surgery*; D016893:Carotid Stenosis / Q000601:surgery*; D002404:Catheterization; D002533:Cerebral Angiography; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D005374:Filtration; D006801:Humans; D020766:Intracranial Embolism / Q000517:prevention & control*; D007431:Intraoperative Complications / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D015607:Stents
chemical_list: D010975:Platelet Aggregation Inhibitors