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Initial multicenter experience with a novel distal protection filter during carotid artery stent implantation
Eberhard Grube1, Antonio Colombo, Eugen Hauptmann
1Heart Center, Siegburg, Germany.
Insights
FilterWire EX provides safe and effective distal cerebral protection during carotid stenting, capturing atheroembolic debris and preventing major adverse events like stroke.
Area of Science:
- Interventional Neurology
- Vascular Surgery
- Cardiology
Background:
- Atheroembolization is a common complication of percutaneous carotid artery intervention.
- Neurologic impairment can be transient or permanent following these procedures.
Purpose of the Study:
- To evaluate the feasibility and safety of FilterWire EX for distal cerebral protection during carotid stenting.
- To assess the rate of embolic material retrieval and major adverse events.
Main Methods:
- Carotid stenting with FilterWire EX distal protection was performed in 36 procedures across six centers.
- Successful FilterWire EX delivery and deployment were achieved in all cases.
- Embolic material retrieval was analyzed post-procedure.
Main Results:
- The FilterWire EX was successfully deployed in all 36 procedures.
- Embolic material was retrieved in 74% of cases.
- The 30-day rate of major adverse events (death, stroke) was 0%.
Conclusions:
- Distal cerebral protection with FilterWire EX is feasible and safe during carotid stenting.
- The device effectively captures atheroembolic debris while maintaining cerebral perfusion.
- This multicenter experience demonstrated high procedural success with no major complications.
Abstract:
Atheroembolization resulting in transient or permanent neurologic impairment is the most common complication of catheter-based percutaneous carotid artery intervention. Protection of the distal cerebral vasculature during carotid stent implantation may enhance procedural safety. Carotid stent implantation with distal cerebral protection using the FilterWire EX was performed in 35 consecutive patients undergoing 36 procedures at six centers. The FilterWire was delivered and deployed successfully in all 36 cases, and embolic material was retrieved from 74% of procedures. The 30-day rate of major adverse events (death, major or minor stroke) was 0%. Transient ipsilateral periprocedural neurologic ischemia developed in two patients (5.7%), both resolving within 30 min. Distal cerebral protection with the FilterWire during carotid stenting is feasible and safe, results in capture and extraction of atheroembolic debris in the majority of patients while affording uninterrupted cerebral perfusion, and in this initial multicenter experience was associated with a high rate of procedural success without major complications.