Distal protection filter device efficacy with carotid artery stenting: comparison between a distal protection filter and a distal protection balloon

详细信息    查看全文

• 作者：Minoru Iko (1)
  Masanori Tsutsumi (2)
  Hiroshi Aikawa (2)
  Yoshihisa Matsumoto (2)
  Yoshinori Go (2)
  Kouhei Nii (1)
  Gorou Abe (1)
  Iwae Ye (1)
  Yasuyuki Nomoto (1)
  Kiyoshi Kazekawa (2)
  
• 关键词：Carotid stenosis ; Stents ; Cerebral infarction ; Diffusion magnetic resonance imaging ; Embolic protection device
• 刊名：Japanese Journal of Radiology
• 出版年：2013
• 出版时间：January 2013
• 年：2013
• 卷：31
• 期：1
• 页码：45-49
• 全文大小：168KB
• 参考文献：1. SPACE Collaborative Group, Ringleb PA, Allenberg J, Brückmann H, Eckstein HH, Fraedrich G, et al. 30?day results from the SPACE trial of stent-protected angioplasty versus carotid endarterectomy in symptomatic patients: a randomised non-inferiority trial. Lancet 2006;368:1239-247 (erratum in Lancet 368;1238).
  2. Yadav JS, Wholey MH, Kuntz RE, Fayad P, Katzen BT, Mishkel GJ, et al. Stenting and angioplasty with protection in patients at high risk for endarterectomy investigators. Protected carotid-artery stenting versus endarterectomy in high-risk patients. N Engl J Med. 2004;351:1493-01. CrossRef
  3. North American Symptomatic Carotid Endarterectomy Trial Collaborators. Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. N Engl J Med. 1991;325:445-3. CrossRef
  4. Kastrup A, Gr?schel K, Krapf H, Brehm BR, Dichgans J, Schulz JB. Early outcome of carotid angioplasty and stenting with and without cerebral protection devices: a systematic review of the literature. Stroke. 2003;34:813-. CrossRef
  5. Kastrup A, N?gele T, Gr?schel K, Schmidt F, Vogler E, Schulz J, et al. Incidence of new brain lesions after carotid stenting with and without cerebral protection. Stroke. 2006;37:2312-. CrossRef
  6. Maynar M, Baldi S, Rostagno R, Zander T, Rabellino M, Llorens R, et al. Carotid stenting without use of balloon angioplasty and distal protection devices: preliminary experience in 100 cases. AJNR Am J Neuroradiol. 2007;28:1378-3. CrossRef
  7. Macdonald S, Evans DH, Griffiths PD, McKevitt FM, Venables GS, Cleveland TJ, et al. Filter-protected versus unprotected carotid artery stenting: a randomized trial. Cerebrovasc Dis. 2010;29:282-. CrossRef
  8. Kim SJ, Roh HG, Jeon P, Kim KH, Lee KH, Byun HS, et al. Cerebral ischemia detected with diffusion-weighted MR imaging after protected carotid artery stenting: comparison of distal balloon and filter device. Korean J Radiol. 2007;8:276-5. CrossRef
  9. Zahn R, Ischinger T, Mark B, Gass S, Zeymer U, Schmalz W, et al. Embolic protection devices for carotid stenting artery stenting: is there a difference between filter and distal occlusive devices? J Am Coll Cardiol. 2005;5:1769-4. CrossRef
  10. Al-Mubarak N, Roubin GS, Vitek JJ, Iyer SS, New G, Leon MB. Effect of the distal-balloon protection system on microembolization during carotid stenting. Circulation. 2001;104:1999-002. CrossRef
  11. Taha MM, Maeda M, Sakaida H, Kawaguchi K, Toma N, Yamamoto A, et al. Cerebral ischemic lesions detected with diffusion-weighted magnetic resonance imaging after carotid artery stenting: comparison of several anti-embolic protection devices. Neurol Med Chir (Tokyo). 2009;49:386-3. CrossRef
  12. Rubartelli P, Brusa G, Arrigo A, Abbadessa F, Giachero C, Vischi M, et al. Transcranial doppler monitoring during stenting of the carotid bifurcation: evaluation of two different distal protection devices in preventing embolization. J Endovasc Ther. 2006;13:436-2. CrossRef
  13. Müller-Hülsbeck S, Jahnke T, Liess C, Glass C, Paulsen F, Grimm J, et al. In vitro comparison of four cerebral protection filters for preventing human plaque embolization during carotid interventions. J Endovasc Ther. 2002;9:793-02. CrossRef
  14. Roffi M, Greutmann M, Schwarz U, Luscher TF, Eberli FR, Amann-Vesti B. Flow impairment during protected carotid artery stenting: impact of filter device design. J Endovasc Ther. 2008;15:103-. CrossRef
  
• 作者单位：Minoru Iko (1)
  Masanori Tsutsumi (2)
  Hiroshi Aikawa (2)
  Yoshihisa Matsumoto (2)
  Yoshinori Go (2)
  Kouhei Nii (1)
  Gorou Abe (1)
  Iwae Ye (1)
  Yasuyuki Nomoto (1)
  Kiyoshi Kazekawa (2)
  
  1. Department of Neurosurgery, Fukuoka Kieikai Hospital, 5-11-5 Chihaya, Higashi-ku, Fukuoka, Fukuoka, 813-0044, Japan
  2. Department of Neurosurgery, Fukuoka University Chikushi Hospital, 1-1-1 Zokumyoin, Chikushino, Fukuoka, 818-8502, Japan
  

文摘

Purpose This retrospective study aimed to compare the effectiveness of the embolization prevention mechanism of two types of embolic protection device (EPD)—a distal protection balloon (DPB) and a distal protection filter (DPF). Methods Subjects were 164 patients scheduled to undergo carotid artery stenting: a DPB was used in 82 cases (DPB group) from April 2007 until June 2010, and a DPF was used in 82 cases (DPF group) from July 2010 to July 2011. Rates of positive findings on postoperative diffusion-weighted imaging (DWI) and stroke incidence were compared. Results Positive postoperative DWI results were found in 34 cases in the DPB group (41.4?%), but in only 22 cases in the DPF group (26.8?%), and there was only a small significant difference within the DPF group. In the DPB group, there was one case of transient ischemic attack (TIA) (1.2?%) and four cases of brain infarction (2 minor strokes, 2 major strokes; 4.9?%), compared to the DFP group with one case of TIA (1.2?%) and no cases of minor or major strokes. Conclusions In this study, significantly lower rates of occurrence of DWI ischemic lesions and intraoperative embolization were associated with use of the DPF compared to the DPB.