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Carotid artery stenting protected with an emboli containment system
Patrick L Whitlow1, Pedro Lylyk, Hugo Londero
1Department of Cardiology, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA. whitlop@ccf.org
Stroke
|May 4, 2002
Summary
Cerebrovasculature protection devices significantly reduce stroke risk during carotid stenting. This study shows successful and safe carotid stenting with a novel emboli entrapment system, aspirating particulate material in all patients.
Area of Science:
- Interventional Cardiology
- Neurology
- Vascular Surgery
Background:
- Carotid stenting carries a risk of distal embolization and stroke.
- Cerebrovascular protection devices aim to mitigate these risks.
Purpose of the Study:
- To evaluate the safety and efficacy of a novel balloon occlusion-aspiration emboli entrapment device during carotid stenting.
- To assess the incidence of emboli and neurological events with this protection system.
Main Methods:
- A multidisciplinary team utilized a balloon occlusion-aspiration system during carotid stenting in 75 patients with severe internal carotid artery stenosis.
- The device features a steerable wire with a balloon for temporary occlusion and an aspiration catheter to remove emboli post-stenting.
Main Results:
- All 75 patients (100%) had particulate material aspirated; no strokes or deaths occurred within 30 days.
- Mean stenosis reduced from 81% to 5%.
- Particulate matter, including plaque debris, was aspirated from all patients, with no post-procedure thrombus or vessel occlusion.
Conclusions:
- Protected carotid stenting with this device is safe and effective.
- Particulate emboli are common during stenting, necessitating cerebral protection.
- Randomized trials comparing protected stenting with endarterectomy are recommended.