Safety of nonprotected carotid artery stenting – a single centre experience

    Authors

    Keywords

    carotid artery stenting, stroke, distal embolic protection

    DOI

    https://doi.org/10.15836/ccar2016.512

    Full Text

    **Introduction:** With careful patient selection and multidisciplinary approach, carotid artery stenting (CAS) showed similar risks and benefits as carotid artery endarterectomy (CEA). Angioplasty of atherosclerotic plaque is the most important step during the CAS because it bears the risk of releasing plaque debris into the intracranial circulation. Distal embolic protection devices were developed to prevent stroke as one of the major complications during the procedure. Due to non-conclusive results of their efficiency in some of major trials and other complications that can theoretically occur during employment of such devices there are large differences in frequency of their use among operators. (1) Objective of this study was to compare incidence of clinical evident stroke in early postprocedural period in patients who had CAS with distal embolic protection with patients who had the same procedure without distal embolic protection. **Patients and Methods:** We retrospectively analyzed data of patients that were endovascularly treated for carotid artery stenosis in our department from 2006 to 2016, and searched for clinical evidence of stroke that could be attributed to the procedure. During that period there was 335 CAS procedures for atherosclerotic stenosis, with 94 procedures with and 241 without distal embolic protection. **Results:** We found no significant difference in periprocedural stroke incidence in two groups of our patients. **Conclusion:** Although our study is retrospective case-control study we displayed safety of our current CAS protocol which does not include distal embolic protection for all patients.

    Literature

    1. Ringleb PA, Kunze A, Allenberg JR, Hennerici MG, Jansen O, Maurer PC, et al. Steering Committee of the SPACE Study. The Stent-Supported Percutaneous Angioplasty of the Carotid Artery vs. Endarterectomy Trial. Cerebrovasc Dis. 2004;18(1):66–8. https://doi.org/10.1159/000078752
    Cardiologia Croatica
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    Safety of nonprotected carotid artery stenting – a single centre experience

    Extended Abstract
    Issue10-11
    Published
    Pages512
    PDF via DOIhttps://doi.org/10.15836/ccar2016.512
    carotid artery stenting
    stroke
    distal embolic protection

    Authors

    Danilo Gardijan*ORCIDUniversity of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
    David OzretićORCIDUniversity of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
    Katarina StarčevićORCIDUniversity of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
    Branko MalojčićUniversity of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
    Zdravka PoljakovićUniversity of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
    Marko RadošUniversity of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia

    *Correspondence email: danilo.gardijan@yandex.com

    Full Text

    Introduction: With careful patient selection and multidisciplinary approach, carotid artery stenting (CAS) showed similar risks and benefits as carotid artery endarterectomy (CEA). Angioplasty of atherosclerotic plaque is the most important step during the CAS because it bears the risk of releasing plaque debris into the intracranial circulation. Distal embolic protection devices were developed to prevent stroke as one of the major complications during the procedure. Due to non-conclusive results of their efficiency in some of major trials and other complications that can theoretically occur during employment of such devices there are large differences in frequency of their use among operators. (1) Objective of this study was to compare incidence of clinical evident stroke in early postprocedural period in patients who had CAS with distal embolic protection with patients who had the same procedure without distal embolic protection.

    Patients and Methods: We retrospectively analyzed data of patients that were endovascularly treated for carotid artery stenosis in our department from 2006 to 2016, and searched for clinical evidence of stroke that could be attributed to the procedure. During that period there was 335 CAS procedures for atherosclerotic stenosis, with 94 procedures with and 241 without distal embolic protection.

    Results: We found no significant difference in periprocedural stroke incidence in two groups of our patients.

    Conclusion: Although our study is retrospective case-control study we displayed safety of our current CAS protocol which does not include distal embolic protection for all patients.

    Literature

    1. 1.
      Ringleb PA, Kunze A, Allenberg JR, Hennerici MG, Jansen O, Maurer PC, et al. Steering Committee of the SPACE Study. The Stent-Supported Percutaneous Angioplasty of the Carotid Artery vs. Endarterectomy Trial. Cerebrovasc Dis. 2004;18(1):66–8.DOI