Abstract | BACKGROUND AND PURPOSE: Periprocedural embolization of debris during carotid stenting interventions may result in neurological deficit. This study was designed to evaluate in-hospital and 30-day adverse events in patients percutaneously treated for carotid artery disease with embolic protection devices. METHODS: RESULTS: The percutaneous procedure was successful in 440 of 442 patients (99.5%). No periprocedural death occurred with any embolic protection device. All in-hospital stroke/death and 30-day ipsilateral stroke/death rate was 1.1%. The overall complication rate was 3.4%. Major adverse events included 1 major stroke (0.2%), 4 intracranial hemorrhages (0.9%), 1 carotid artery wall fissuration (0.2%), and 1 diffuse cardioembolism (0.2%). Minor adverse events included 4 minor strokes (0.9%) and 4 transient ischemic attacks (0.9%). The cerebral protection device-related complications were 4 (0.9%): 1 case of abrupt closure of the internal carotid artery because of spiral dissection (0.2%), 1 case of trapped guide wire (0.2%), and 2 cases of intimal dissection (0.5%). Transient loss of consciousness, tremors, and fasciculations were present in 6 of 40 patients (15%) in whom occlusive protection devices were used. CONCLUSIONS: Our data suggest that percutaneous stenting of the carotid artery when a cerebral protection device is used is feasible and effective but not without potential complications. However, a long learning curve may exist for the proper use of some embolic protection devices.
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Authors | Alberto Cremonesi, Raffaella Manetti, Francesco Setacci, Carlo Setacci, Fausto Castriota |
Journal | Stroke
(Stroke)
Vol. 34
Issue 8
Pg. 1936-41
(Aug 2003)
ISSN: 1524-4628 [Electronic] United States |
PMID | 12843347
(Publication Type: Clinical Trial, Journal Article)
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Topics |
- Aged
- Blood Vessel Prosthesis Implantation
(adverse effects, instrumentation)
- Carotid Arteries
(diagnostic imaging, surgery)
- Carotid Artery Diseases
(surgery)
- Carotid Artery, Internal, Dissection
(etiology)
- Embolism
(etiology, prevention & control)
- Feasibility Studies
- Female
- Filtration
(instrumentation, methods)
- Hospital Mortality
- Humans
- Ischemic Attack, Transient
(etiology, prevention & control)
- Male
- Postoperative Complications
(etiology, prevention & control)
- Prostheses and Implants
(adverse effects)
- Safety
- Stents
(adverse effects)
- Stroke
(etiology, prevention & control)
- Treatment Outcome
- Ultrasonography
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