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Published on: July 9, 2020
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Carotid Artery Stenting Using the Walrus Balloon Guide Catheter With Flow Reversal for Proximal Embolic Protection:
Justin M Cappuzzo1,2, Andre Monteiro1,2, Muhammad Waqas1,2
1Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA.
Operative Neurosurgery (Hagerstown, Md.)
|October 17, 2022
Summary
This study shows that using the Walrus balloon guide catheter (BGC) for flow reversal during carotid artery stenting is a safe and effective embolic protection method. The technique achieved 100% technical success with no periprocedural strokes.
Area of Science:
- Interventional Cardiology
- Vascular Surgery
- Neurosurgery
Background:
- Carotid artery stenting (CAS) requires effective embolic protection.
- Transfemoral balloon guide catheters (BGCs) offer a promising approach for flow reversal during CAS.
- Literature on BGCs for flow reversal in CAS is limited.
Purpose of the Study:
- To describe a novel flow-reversal technique utilizing the Walrus BGC.
- To report the initial clinical experience and outcomes at our center.
Main Methods:
- Retrospective analysis of 105 patients undergoing elective CAS with Walrus BGC flow reversal (July 2020-September 2021).
- Evaluation of patient demographics, procedural details, and clinical follow-up.
- Inclusion criteria: age ≥18 years, elective CAS with Walrus BGC flow reversal.
Main Results:
- 100% technical success rate for stenting.
- No periprocedural transient ischemic attacks (TIAs) or strokes observed.
- Two strokes (1.9%) and one death (0.9%) occurred within 30-day follow-up.
Conclusions:
- The Walrus BGC flow reversal technique is safe, feasible, and efficient for embolic protection during CAS.
- The technique demonstrated excellent technical success and low periprocedural complication rates.
- Further research is warranted to define the role of proximal protection with BGC-based flow reversal.
