Carotid Revascularization with and without the Use of an Embolic Protection Device: A Single-Center Experience from

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Qasim Bashir1,2, Ammad Anwar Baig3

  • 1Department of Neurointervention, Bahria Town Hospital, Lahore, Pakistan.

Interventional Neurology
|November 10, 2018
PubMed

Insights

Carotid artery stenting without embolic protection devices (EPD) is safe and effective for patients with carotid disease. This approach is also cost-effective, reducing unnecessary disposable use in experienced hands.

Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Neurology

Background:

  • Carotid artery stenting is a common procedure for treating carotid artery disease.
  • The use of embolic protection devices (EPD) during stenting is debated.
  • Assessing the safety and efficacy of stenting with and without EPD is crucial for patient outcomes.

Purpose of the Study:

  • To evaluate the safety and clinical efficacy of carotid artery stenting (CAS) with and without embolic protection devices (EPD).
  • To compare outcomes in both symptomatic and asymptomatic patients with carotid disease.

Main Methods:

  • Retrospective review of 55 carotid disease cases undergoing stenting/angioplasty.
  • Inclusion criteria based on degree of carotid artery occlusion via digital subtraction angiography (DSA), ultrasound, CTA, and MRA.
  • Primary endpoints included periprocedural stroke, myocardial infarction, death, and long-term ipsilateral stroke.

Main Results:

  • 92.7% of patients were symptomatic with a mean stenosis of 80.1%.
  • EPD was used selectively in 20% of cases.
  • A low rate of minor stroke (1.8%) was observed with EPD use; no myocardial infarction or mortality. No strokes occurred during follow-up.

Conclusions:

  • Carotid revascularization with stenting and angioplasty without EPD is safe and effective in experienced centers.
  • This approach is cost-effective by minimizing the use of disposable devices.
  • Further large-scale randomized trials are warranted to confirm these findings.
Abstract

Keywords:
Carotid artery stentingEmbolic protection deviceInterventionStroke

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