title: Carotid Artery Angioplasty and Stenting Without Distal Embolic Protection Devices.
abstract: Embolic protection devices are used during carotid artery stenting procedures to reduce risk of distal embolization. Although this is a standard procedural recommendation, no studies have shown superiority of these devices over unprotected stenting procedures.
  
  
  
  To assess the periprocedural outcome and durability of carotid artery stenting without embolic protection devices and poststent angioplasty.
  
  
  
  We performed a retrospective chart review of 174 carotid angioplasty stent procedures performed at our institution. One hundred sixty-six patients underwent angioplasty and stenting without distal protection devices or poststent angioplasty. Complications related to stenting, including procedural complications, postoperative stroke and/or myocardial infarction, and stent restenosis were analyzed.
  
  
  
  One hundred thirty-five stents (78%) were performed in symptomatic patients, whereas 22% of stents were placed for asymptomatic internal carotid artery stenosis. The degree of stenosis was 80% or greater in 75% of patients and 90% or greater in 55% of patients. Following the stenting procedure, the 24-hour and 30-day rate of transient ischemic attack, intracranial hemorrhage, or ischemic stroke was 0. Three (2%) patients had a perioperative, non-ST elevation myocardial infarction. Five patients (2.8%) required treatment for restenosis (>50% stenosis from baseline), 1 of which was symptomatic.
  
  
  
  Our data show that carotid artery stenting without the use of embolic protection devices and without postangioplasty stenting, in experienced hands, can be performed safely. Furthermore, this technique does not result in a higher degree of in-stent restenosis than series in which poststenting angioplasty is performed.
authors.affiliation: Drexel Neurosciences Institute, Philadelphia, Pennsylvania.
authors.forename: Mandy J
authors.initials: MJ
authors.lastname: Binning
authors.affiliation: Drexel Neurosciences Institute, Philadelphia, Pennsylvania.
authors.forename: Christina R
authors.initials: CR
authors.lastname: Maxwell
authors.affiliation: Tennova Neurosciences, Knoxville, Tennessee.
authors.forename: Douglas
authors.initials: D
authors.lastname: Stofko
authors.affiliation: Capital Health Regional Medical Center and Capital Institutes for Neurosciences, Trenton and Pennington, New Jersey.
authors.forename: Myra
authors.initials: M
authors.lastname: Zerr
authors.affiliation: Capital Health Regional Medical Center and Capital Institutes for Neurosciences, Trenton and Pennington, New Jersey.
authors.forename: Kamyar
authors.initials: K
authors.lastname: Maghazehe
authors.affiliation: Drexel Neurosciences Institute, Philadelphia, Pennsylvania.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Liebman
authors.affiliation: Drexel Neurosciences Institute, Philadelphia, Pennsylvania.
authors.forename: Zakaria
authors.initials: Z
authors.lastname: Hakma
authors.affiliation: Capital Health Regional Medical Center and Capital Institutes for Neurosciences, Trenton and Pennington, New Jersey.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Lewis-Diaz
authors.affiliation: Drexel Neurosciences Institute, Philadelphia, Pennsylvania.
authors.forename: Erol
authors.initials: E
authors.lastname: Veznedaroglu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty; D016893:Carotid Stenosis / Q000601:surgery*; D057505:Embolic Protection Devices; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome
keywords: Angioplasty; Carotid artery; Embolic protection device; Stenting