Document Detail


Effect of two different neuroprotection systems on microembolization during carotid artery stenting.
MedLine Citation:
PMID:  15542277     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: This study sought to compare the efficacy of two different cerebral protection systems for the prevention of embolization during carotid artery stenting (CAS) using a transcranial Doppler (TCD) monitoring with the detection of microembolic signals (MES). BACKGROUND: Despite the introduction of cerebral protection systems, neurologic complications during CAS cannot completely be prevented. Transcranial Doppler and detection of MES may aid in assessing the efficacy of different neuroprotection systems. METHODS: A total of 42 patients with internal carotid artery stenoses were treated by CAS using either a filter (E.P.I. FilterWire, Boston Scientific Corp., Santa Clara, California) (n = 21) or a proximal endovascular clamping device (MO.MA system, Invatec s.r.l., Roncadelle, Italy) (n = 21). Microembolic signal counts were compared during five phases: placement of the protection device, passage of the stenosis, stent deployment, balloon dilation, and retrieval of the protection device. RESULTS: There were no significant differences in clinical or angiographic outcomes between the two groups. Compared to the filter device, the MO.MA system significantly reduced MES counts during the procedural phases of wire passage of the stenosis, stent deployment, balloon dilation, and in total (MES counts for the filter device were 25 +/- 22, 73 +/- 49, 70 +/- 31, and 196 +/- 84 during the three phases and in total, MES counts for the MO.MA system were 1.8 +/- 3.2, 11 +/- 19, 12 +/- 21, and 57 +/- 41, respectively; p < 0.0001). CONCLUSIONS: In comparison to a filter device the MO.MA system led to significantly lower MES counts during CAS. The detection of MES by TCD may facilitate the evaluation and comparison of different neuroprotection systems.
Authors:
Andrej Schmidt; Klaus-Werner Diederich; Susanne Scheinert; Sven Bräunlich; Tatjana Olenburger; Giancarlo Biamino; Gerhard Schuler; Dierk Scheinert
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  44     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2004 Nov 
Date Detail:
Created Date:  2004-11-15     Completed Date:  2004-12-02     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1966-9     Citation Subset:  AIM; IM    
Affiliation:
Division of Clinical and Interventional Angiology, Department of Cardiology, University of Leipzig-Heart Center, Leipzig, Germany. Andrej.Schmidt@gmx.de
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MeSH Terms
Descriptor/Qualifier:
Aged
Balloon Dilatation / instrumentation*
Blood Vessel Prosthesis Implantation / adverse effects
Carotid Stenosis / surgery*
Cerebral Angiography
Female
Humans
Intracranial Embolism / prevention & control*,  radiography,  ultrasonography
Male
Stents / adverse effects
Treatment Outcome
Ultrasonography, Doppler, Transcranial
Comments/Corrections
Comment In:
J Am Coll Cardiol. 2005 Jul 19;46(2):382   [PMID:  16022975 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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