title: Comparison of periprocedural and long term outcomes of proximal versus distal cerebral protection method during carotid artery stenting.
abstract: BACKGROUND
  The aim of this study was to assess the periprocedural and one-year outcomes of two different cerebral protection systems used during carotid artery stenting (CAS).
  
  
  METHODS
  We enrolled 90 consecutive patients with carotid artery stenosis who underwent CAS with a proximal flow blockage protection system (mean age 69.7 ± 8) or distal protection with a filter (mean age 70.8 ± 7).
  
  
  RESULTS
  CAS was performed successively on 89 patients (99 %). Adverse events were defined as major stroke, minor stroke, transient ischemic attack (TIA), myocardial infarction, and death. Two strokes, one TIA, one death, and one myocardial infarction were observed in-hospital. There were no significant differences in safety or benefits between the proximal flow blockage embolic protection system (n = 45) and the distal filter protection system (n = 45) in terms of clinically apparent cerebral embolism, TIA, death, or myocardial infarction during the periprocedural stage or during the one-year follow-up period.
  
  
  CONCLUSIONS
  Although it has been shown that the proximal flow blockage cerebral protection system decreases the risk of silent cerebral embolism, it has no advantage over the distal filter protection system in terms of adverse cerebrovascular or cardiac events during the periprocedural stage or during the long-term follow-up period.
authors: 1 Department of Neurology, Dr. Mazhar Osman Teaching and Research Hospital for Mental Health and Neurological Disorders, Istanbul, Turkey.
authors: Zeynep
authors: Z
authors: Bastug Gul
authors: Emre
authors: E
authors: Akkaya
authors: Ertan
authors: E
authors: Vuruskan
authors: Ozgur
authors: O
authors: Akgul
authors: Hamdi
authors: H
authors: Pusuroglu
authors: Ozgur
authors: O
authors: Surgit
authors: Sinem
authors: S
authors: Ozbay Ozyilmaz
authors: Aydin
authors: A
authors: Rodi Tosu
authors: Huseyin
authors: H
authors: Altug Cakmak
authors: Safa
authors: S
authors: Gode
authors: Mehmet
authors: M
authors: Gul
mesh_terms: D000368:Aged; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000379:methods; D017536:Carotid Artery, Common / Q000601:surgery*; D016893:Carotid Stenosis / Q000601:surgery*; D038524:Diffusion Magnetic Resonance Imaging; D057505:Embolic Protection Devices; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011300:Preoperative Care / Q000295:instrumentation*; D015607:Stents; D020521:Stroke / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D013997:Time Factors; D016896:Treatment Outcome
keywords: Proximal flow blockage protection system; distal protection with a filter; major adverse cerebral and cardiovascular events