Related Experiment Videos
Proximal endovascular flow blockage for cerebral protection during carotid artery stenting: results from a
Bernhard Reimers1, Horst Sievert, Gerhard C Schuler
1Cardiology Department, Ospedale Civile, Mirano, Italy. emodinamica@ulss13mirano.ven.it
Insights
Cerebral protection using the Mo.Ma device during carotid artery stenting (CAS) is feasible. This method effectively reduces embolization, showing a high procedural success rate and low complication rates in patients with carotid stenosis.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Neurology
Background:
- Carotid artery stenting (CAS) is a common procedure to treat carotid artery stenosis.
- Cerebral embolization is a significant risk during CAS.
- The Mo.Ma device offers a method for cerebral protection during CAS.
Purpose of the Study:
- To evaluate the feasibility of cerebral protection during CAS using the Mo.Ma device.
- To assess the safety and efficacy of the Mo.Ma device in preventing cerebral embolization.
Main Methods:
- A prospective registry of 157 patients undergoing CAS with the Mo.Ma device across 14 European centers.
- The Mo.Ma device utilizes proximal endovascular blockage of blood flow in the internal and external carotid arteries.
- Blood was aspirated to capture embolic debris.
Main Results:
- Successful device positioning and stent implantation in all cases.
- Significant reduction in diameter stenosis from 84.1% to 6.7%.
- Macroscopic evidence of embolic debris in 79.6% of cases.
- Low in-hospital complication rates: 2.5% minor strokes, 5.1% TIAs.
- 30-day death/stroke rate of 5.7%, with a major stroke and death rate of 1.3%.
Conclusions:
- Cerebral protection with proximal endovascular blood flow blockage during CAS is feasible.
- The Mo.Ma device demonstrates a high procedural success rate.
- The Mo.Ma system is effective in capturing embolic debris during CAS.
Purpose:
To evaluate the feasibility of cerebral protection during carotid artery stenting (CAS) using the Mo.Ma device, which prevents cerebral embolization by proximal endovascular blockage of blood flow in the internal and external carotid arteries.
Methods:
In 14 European centers, 157 patients (121 men; mean age 68.0+/-8.3 years) were enrolled in a prospective registry between March 2002 and March 2003. Eligible patients had a symptomatic (>50%) or asymptomatic (>70%) stenosis of the internal carotid artery suitable for carotid stenting. Protected carotid stenting was performed with the Mo.Ma system, which occludes both the common and external carotid arteries via 2 independently inflatable compliant low-pressure balloons before any device is advanced across the lesion. Blood is aspirated through the catheter intermittently or at the end of the procedure.
Results:
The device was successfully positioned and stents were implanted in all cases. Diameter stenosis was reduced from 84.1%+/-7.8% to 6.7%+/-5.1%. The mean duration of flow blockage was 7.6+/-5.9 minutes. In 12 (7.6%) patients, transient intolerance to flow blockade was observed, but the procedures were completed successfully. In 124 (79.6%) cases, there was macroscopic evidence of debris after filtering the aspirated blood. In-hospital complications included 4 (2.5%) minor strokes, 8 (5.1%) transient ischemic attacks, no deaths, and no major strokes, resulting in a 2.5% death/stroke rate at discharge. At 30-day follow-up, there was 1 cardiac death, 1 major stroke, and 3 minor strokes, for an overall 5.7% 30-day death/stroke rate and a 30-day major stroke and death rate of 1.3%.
Conclusions:
Cerebral protection with proximal endovascular blood flow blockage during CAS is feasible, with a high procedural success rate.