Document Detail


The association of clinical variables and filter design with carotid artery stenting thirty-day outcome.
MedLine Citation:
PMID:  21530332     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Patient and device selection are important for the success of carotid artery stenting (CAS). We hypothesize that distal protection filter (DPF) design characteristics that minimize blood flow resistance and maximize capture efficiency are associated with the absence of transient ischemic attack (TIA), stroke and neurologic-related death after 30 days.
METHODS: Records from 208 patients were reviewed retrospectively. Filter design characteristics were quantified previously in our laboratory. The association between risk factors and design characteristics with 30-day outcome was quantified using univariate analysis.
RESULTS: The 30-day all-cause stroke and death rate was 8.7% (asymptomatic: 7.7%, symptomatic: 10.6%). Five DPFs were used in the study: Accunet (41.3%), Angioguard (33.2%), FilterWire (24%), Emboshield (1%), and Spider (.5%). Diabetes (P = .04) and prior carotid endarterectomy (CEA, P = .03) were associated with adverse outcome. Prior stroke (P = .01) and prior CEA (P = .04) were significant for peri-procedural stroke. Design characteristics such as capture efficiency were associated with favorable outcomes.
CONCLUSIONS: Patients with prior CEA or stroke are more likely to have unfavorable CAS outcomes after 30 days. Filters with high capture efficiency may yield the best clinical results. Analysis of the effect of design characteristics on CAS outcome should aid the design of future devices.
Authors:
G M Siewiorek; R T Krafty; M H Wholey; E A Finol
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2011-04-29
Journal Detail:
Title:  European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery     Volume:  42     ISSN:  1532-2165     ISO Abbreviation:  Eur J Vasc Endovasc Surg     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-08-17     Completed Date:  2011-10-13     Revised Date:  2013-05-24    
Medline Journal Info:
Nlm Unique ID:  9512728     Medline TA:  Eur J Vasc Endovasc Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  282-91     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.
Affiliation:
Biomedical Engineering Department, Carnegie Mellon University, 1210 Hamburg Hall, 5000 Forbes Avenue, Pittsburgh, PA 15213, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Arterial Occlusive Diseases / surgery*
Carotid Artery Diseases / surgery*
Endovascular Procedures / instrumentation*
Equipment Design
Female
Humans
Male
Retrospective Studies
Stents*
Grant Support
ID/Acronym/Agency:
T32 EB003392-01A1/EB/NIBIB NIH HHS
Comments/Corrections

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