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Periprocedural Embolic Events Related to Carotid Artery Stenting Detected by Diffusion-Weighted MRI: Comparison between Proximal and Distal Embolus Protection Devices
Purpose: To evaluate and compare the efficacy of proximal versus distal embolus protection devices (EPD) during carotid artery angioplasty/stenting (CAS) based on diffusion-weighted magnetic resonance imaging (DW-MRI). Methods: Forty-four patients (31 men; mean age 68 years, range 48–85) underwent p...
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Published in: | Journal of endovascular therapy 2007-06, Vol.14 (3), p.293-303 |
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Main Authors: | , , , , , , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that this one cites Items that cite this one |
Online Access: | Get full text |
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Summary: | Purpose:
To evaluate and compare the efficacy of proximal versus distal embolus protection devices (EPD) during carotid artery angioplasty/stenting (CAS) based on diffusion-weighted magnetic resonance imaging (DW-MRI).
Methods:
Forty-four patients (31 men; mean age 68 years, range 48–85) underwent protected CAS and had DW-MRI before and after the intervention. The cohort was analyzed according to the type of EPD used: a proximal EPD was deployed in 25 (56.8%) patients (17 men; mean age 66 years, range 48–85) and a distal filter in 19 (14 men; mean age 70 years, range 58–79). Fifteen (60.0%) patients with proximal protection were symptomatic of the target lesion; in the distal protection group, 10 (52.6%) were symptomatic.
Results:
New lesions were seen on the postinterventional DW-MRI in 28.0% (7/25) of the proximal EPD group versus 32.6% (6/19) of those with a distal filter (p=NS). The majority were clinically silent. The new lesions in the vascular territory of the stented carotid artery in the group as a whole and per patient were fewer in the proximal EPD group (p=NS). No significant differences were noted in the T2 appearance of the new lesions or the number of new lesions observed away from the vascular territory of the stented artery.
Conclusion:
Proximal embolus protection devices show a nonsignificant trend toward fewer embolic events, which warrants large-scale studies. Furthermore, proximal protection devices can be useful to control and treat acute in-stent thrombosis. |
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ISSN: | 1526-6028 1545-1550 |
DOI: | 10.1583/06-1990.1 |