| Periprocedural embolic events related to carotid artery stenting detected by diffusion-weighted MRI: comparison between proximal and distal embolus protection devices. | |
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MedLine Citation:
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PMID: 17723007 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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 T(2) 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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Authors:
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Marwan El-Koussy; Gerhard Schroth; Dai-Do Do; Jan Gralla; Krassen Nedeltchev; Ferdinand von Bredow; Luca Remonda; Caspar Brekenfeld |
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Publication Detail:
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Type: Comparative Study; Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists Volume: 14 ISSN: 1526-6028 ISO Abbreviation: J. Endovasc. Ther. Publication Date: 2007 Jun |
Date Detail:
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Created Date: 2007-08-28 Completed Date: 2007-09-21 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100896915 Medline TA: J Endovasc Ther Country: United States |
Other Details:
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Languages: eng Pagination: 293-303 Citation Subset: IM |
Affiliation:
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Institute for Diagnostic and Interventional Neuroradiology, University of Bern, Inselspital, Bern, Switzerland. marwan.el-koussy@insel.ch |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Angioplasty, Balloon / adverse effects*, instrumentation Carotid Stenosis / pathology, therapy* Diffusion Magnetic Resonance Imaging* Embolism / diagnosis*, etiology, prevention & control Female Follow-Up Studies Humans Magnetic Resonance Angiography / methods* Male Middle Aged Prosthesis Design Severity of Illness Index Stents* Time Factors Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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