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Distal protection filter device efficacy with carotid artery stenting: comparison between a distal protection filter
Minoru Iko1, Masanori Tsutsumi, Hiroshi Aikawa
1Department of Neurosurgery, Fukuoka Kieikai Hospital, 5-11-5 Chihaya, Higashi-ku, Fukuoka, Fukuoka 813-0044, Japan. ikominoru@hotmail.com
Insights
The distal protection filter (DPF) demonstrated superior embolization prevention compared to the distal protection balloon (DPB) during carotid artery stenting, resulting in fewer ischemic lesions and strokes.
Area of Science:
- Interventional Cardiology
- Neurology
- Medical Device Technology
Background:
- Carotid artery stenting (CAS) is a procedure to prevent stroke.
- Embolic protection devices (EPDs) are used to reduce the risk of embolization during CAS.
- Two main types of EPDs are distal protection balloons (DPBs) and distal protection filters (DPFs).
Purpose of the Study:
- To compare the effectiveness of DPB versus DPF in preventing embolization during CAS.
- To evaluate the rates of new ischemic lesions and stroke incidence between the two EPD types.
Main Methods:
- Retrospective study of 164 patients undergoing CAS.
- 82 patients received DPB (April 2007-June 2010).
- 82 patients received DPF (July 2010-July 2011).
- Postoperative diffusion-weighted imaging (DWI) and stroke incidence were compared.
Main Results:
- Lower rates of positive DWI findings in the DPF group (26.8%) compared to the DPB group (41.4%).
- DPF group had no strokes, while the DPB group experienced 4.9% stroke incidence (2 minor, 2 major).
- Transient ischemic attack (TIA) rates were similar between groups (1.2%).
Conclusions:
- DPF is associated with significantly lower rates of DWI ischemic lesions and intraoperative embolization compared to DPB.
- DPF may offer improved safety in preventing cerebral ischemia during CAS.
- Further prospective studies are warranted to confirm these findings.
Purpose:
This retrospective study aimed to compare the effectiveness of the embolization prevention mechanism of two types of embolic protection device (EPD)-a distal protection balloon (DPB) and a distal protection filter (DPF).
Methods:
Subjects were 164 patients scheduled to undergo carotid artery stenting: a DPB was used in 82 cases (DPB group) from April 2007 until June 2010, and a DPF was used in 82 cases (DPF group) from July 2010 to July 2011. Rates of positive findings on postoperative diffusion-weighted imaging (DWI) and stroke incidence were compared.
Results:
Positive postoperative DWI results were found in 34 cases in the DPB group (41.4 %), but in only 22 cases in the DPF group (26.8 %), and there was only a small significant difference within the DPF group. In the DPB group, there was one case of transient ischemic attack (TIA) (1.2 %) and four cases of brain infarction (2 minor strokes, 2 major strokes; 4.9 %), compared to the DFP group with one case of TIA (1.2 %) and no cases of minor or major strokes.
Conclusions:
In this study, significantly lower rates of occurrence of DWI ischemic lesions and intraoperative embolization were associated with use of the DPF compared to the DPB.
