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Updated: Jul 7, 2026
Bilateral Common Carotid Artery Occlusion as an Adequate Preconditioning Stimulus to Induce Early Ischemic Tolerance to Focal Cerebral Ischemia
Published on: May 9, 2013
Initial evaluation of carotid angioplasty and stenting with three different cerebral protection devices
J C Parodi1, R La Mura, L M Ferreira
1Department of Vascular Surgery, Instituto Cardiovascular Buenos Aires, Argentina. jparodi@sanofi.com.ar
Insights
Cerebral protection devices appear effective in preventing neurologic complications during carotid artery stenting. While not statistically significant in this study, no events occurred in the protected group, warranting further investigation.
Area of Science:
- Interventional Cardiology
- Neurology
- Vascular Surgery
Background:
- Severe carotid artery stenosis poses a risk of stroke.
- Carotid angioplasty and stenting are established revascularization procedures.
- Minimizing embolic events during these procedures is crucial.
Purpose of the Study:
- To evaluate the efficacy of cerebral protection devices (CPDs) in carotid artery stenting (CAS).
- To assess the impact of CPDs on perioperative neurologic complications and mortality.
Main Methods:
- Prospective study of 46 patients undergoing CAS between 1998-1999.
- Comparison between patients with (n=25) and without CPDs.
- Primary endpoints: perioperative neurologic deficits and mortality.
Main Results:
- Overall complication and mortality rate was 4.34%.
- No neurologic events occurred in the CPD group versus 9.53% in the unprotected group (not statistically significant).
- CPDs successfully captured embolic particles of various sizes.
Conclusions:
- Cerebral protection during CAS is technically feasible.
- CPDs show promise in reducing procedure-related neurologic complications.
- Further research is recommended to confirm efficacy.
Objective:
The purpose of the study was to assess the effectiveness of cerebral protection devices during carotid artery angioplasty and stent placement.
Methods:
Between September 1998 and September 1999, carotid angioplasty and stenting were performed in 46 patients with symptomatic (39.1%) or asymptomatic (60.9%) severe carotid artery stenosis. Wallstents were used in all patients with selective predilatation. Cerebral protection devices were used in 25 of these patients. Primary end points were perioperative neurologic complications and mortality. Data were collected prospectively.
Results:
The overall combined end point of all neurologic deficits and death rate was 4.34%. Two neurologic events (one transient ischemic attack and one minor stroke) occurred in the unprotected group (9.53%) versus none in the group with cerebral protection. This difference is not statistically significant. The mortality rate was 0% for both groups. On an intention to treat basis, the overall technical success rate for carotid angioplasty was 97.8%, and for placement of cerebral protection devices it was 100%. An important number of particles of different sizes were captured in all cases in which cerebral protection devices were used.
Conclusion:
Experience has shown that cerebral protection during carotid angioplasty and stenting is technically feasible and appears to be effective in preventing procedure-related neurologic complications. Further investigation is warranted.
