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A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
Carotid angioplasty and stenting: lesion related treatment strategies
Alberto Cremonesi1, Carlo Setacci, Raffaella Manetti
1Interventional Cardio-Angiology Unit, Villa Maria Cecilia Hospital, Cotignola (RA), Italy.
Insights
Tailored carotid artery stenting (CAS) using specific embolic protection devices (EPDs) and stents proved safe and effective for severe disease. This approach achieved 100% procedural success with low rates of stroke and death.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Medical Device Technology
Background:
- Severe carotid artery disease poses a significant risk of stroke.
- Carotid angioplasty and stenting (CAS) is a common treatment, but requires careful consideration of lesion-specific strategies.
- Embolic Protection Devices (EPDs) aim to reduce stroke risk during CAS.
Purpose of the Study:
- To assess the feasibility and safety of lesion-tailored CAS strategies using various embolic protection devices (EPDs).
- To evaluate the procedural success and complication rates of CAS in patients with severe carotid artery disease.
Main Methods:
- A prospective study of 377 patients undergoing CAS between December 2001 and August 2004.
- Utilized diverse stent types (cobalt-alloy, nitinol) and EPDs (filter-wires, proximal clamping devices) based on lesion characteristics.
- Monitored primary endpoints of death and stroke rates at discharge, and secondary endpoints including angiographic success and 30-day outcomes.
Main Results:
- 100% procedural success (377/377 patients).
- Low adverse event rates: 1.06% stroke/death at discharge, 1.33% overall procedure-related stroke and death.
- Specific adverse events included transient ischemic attacks (TIAs), major/minor strokes, procedure-related death, and intracranial hemorrhage.
Conclusions:
- Matching new materials and devices to specific lesions and anatomies for CAS is safe and effective.
- Tailored CAS strategies with EPDs can be successfully implemented in patients with severe carotid artery disease.
Aims:
To evaluate the feasibility of lesion related treatment strategies in patients treated for severe carotid artery disease with angioplasty and stenting (CAS) under embolic protection devices (EPD).
Methods And Results:
From December 2001 to August 2004 a total of 377 consecutive patients were enrolled to undergo CAS. The procedure was conducted by using several types of stents (cobalt-alloy frame, nitinol frame) and of EPD (filter-wires, proximal endovascular clamping devices) applied to specific lesions and/or anatomies.Primary endpoint was to assess the death and stroke rate at discharge.Secondary endpoints were to test the feasibility and safety of tailored CAS (angiographic success, any -complication between discharge and 30 days, death of any cause at 30 days).The procedural success was achieved in 377/377 patients (100%).Adverse events included:1. during procedure: 2 TIAs (0.53%)2. at discharge: 1 death procedure related (0.27%), 1 major stroke (0.27%), 2 minor strokes (0.53%), 4 TIAs (1.06%), 1 intracranial hemorrhage (0.27%); all adverse event rate at discharge 2.92%; all strokes and death rate at discharge 1.06%;3. at 30 day f.u.: one death not procedure related (0.27%), 1 minor stroke (0.27%);4. overall procedure related stroke and death rate: 1.33%.
Conclusions:
Our data suggest that using new materials/devices matched to specific lesions or anatomies is safe and effective.
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