Multicenter evaluation of carotid artery stenting with a filter protection system

Nadim Al-Mubarak, Antonio Colombo, Peter A. Gaines, Sriram S. Iyer, Nicola Corvaja, Trevor J. Cleveland, Sumaira Macdonald, Cristina Brennan, Jiri J. Vitek

Research output: Contribution to journalArticle

173 Citations (Scopus)

Abstract

OBJECTIVES: The aim of this study was to evaluate the feasibility and safety of carotid artery stenting (CAS) with a filter protection system. BACKGROUND: Neurologic events linked to the embolization of particulate matter to the cerebral circulation may complicate CAS. Strategies designed to capture embolic particles during carotid intervention are being evaluated for their efficacy in reducing the risk of these events. METHODS: Between September 1999 and July 2001, a total of 162 patients (164 hemispheres) underwent CAS with filter protection (NeuroShield, MedNova Ltd., Galway, Ireland) according to prospective protocols evaluating the filter system at three institutions. RESULTS: Angiographic success was achieved in 162 of the procedures (99%) and filter placement was successful in 154 (94%) procedures. Carotid access was unsuccessful in two cases (1%) and filter placement in eight cases (5%). Of the latter, five procedures were completed with no protection and three were completed using alternative protection devices. On an intention-to-treat basis, the overall combined 30-day rate of all-stroke and death was 2% (four events: two minor strokes and two deaths). This includes one minor stroke in a patient with failed filter placement and CAS completed without protection. There was one cardiac arrhythmic death and one death from hyperperfusion-related intracerebral hemorrhage. There were no major embolic strokes. CONCLUSIONS: Carotid artery stenting with filter protection is technically feasible and safe. Early clinical outcomes appear to be favorable and need to be confirmed in a larger comparative study.

Original languageEnglish
Pages (from-to)841-846
Number of pages6
JournalJournal of the American College of Cardiology
Volume39
Issue number5
DOIs
Publication statusPublished - Mar 6 2002

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Carotid Arteries
Stroke
Cerebrovascular Circulation
Particulate Matter
Cerebral Hemorrhage
Ireland
Nervous System
Safety
Equipment and Supplies

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Al-Mubarak, N., Colombo, A., Gaines, P. A., Iyer, S. S., Corvaja, N., Cleveland, T. J., ... Vitek, J. J. (2002). Multicenter evaluation of carotid artery stenting with a filter protection system. Journal of the American College of Cardiology, 39(5), 841-846. https://doi.org/10.1016/S0735-1097(02)01692-3

Multicenter evaluation of carotid artery stenting with a filter protection system. / Al-Mubarak, Nadim; Colombo, Antonio; Gaines, Peter A.; Iyer, Sriram S.; Corvaja, Nicola; Cleveland, Trevor J.; Macdonald, Sumaira; Brennan, Cristina; Vitek, Jiri J.

In: Journal of the American College of Cardiology, Vol. 39, No. 5, 06.03.2002, p. 841-846.

Research output: Contribution to journalArticle

Al-Mubarak, N, Colombo, A, Gaines, PA, Iyer, SS, Corvaja, N, Cleveland, TJ, Macdonald, S, Brennan, C & Vitek, JJ 2002, 'Multicenter evaluation of carotid artery stenting with a filter protection system', Journal of the American College of Cardiology, vol. 39, no. 5, pp. 841-846. https://doi.org/10.1016/S0735-1097(02)01692-3
Al-Mubarak, Nadim ; Colombo, Antonio ; Gaines, Peter A. ; Iyer, Sriram S. ; Corvaja, Nicola ; Cleveland, Trevor J. ; Macdonald, Sumaira ; Brennan, Cristina ; Vitek, Jiri J. / Multicenter evaluation of carotid artery stenting with a filter protection system. In: Journal of the American College of Cardiology. 2002 ; Vol. 39, No. 5. pp. 841-846.
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AU - Gaines, Peter A.

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AU - Corvaja, Nicola

AU - Cleveland, Trevor J.

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N2 - OBJECTIVES: The aim of this study was to evaluate the feasibility and safety of carotid artery stenting (CAS) with a filter protection system. BACKGROUND: Neurologic events linked to the embolization of particulate matter to the cerebral circulation may complicate CAS. Strategies designed to capture embolic particles during carotid intervention are being evaluated for their efficacy in reducing the risk of these events. METHODS: Between September 1999 and July 2001, a total of 162 patients (164 hemispheres) underwent CAS with filter protection (NeuroShield, MedNova Ltd., Galway, Ireland) according to prospective protocols evaluating the filter system at three institutions. RESULTS: Angiographic success was achieved in 162 of the procedures (99%) and filter placement was successful in 154 (94%) procedures. Carotid access was unsuccessful in two cases (1%) and filter placement in eight cases (5%). Of the latter, five procedures were completed with no protection and three were completed using alternative protection devices. On an intention-to-treat basis, the overall combined 30-day rate of all-stroke and death was 2% (four events: two minor strokes and two deaths). This includes one minor stroke in a patient with failed filter placement and CAS completed without protection. There was one cardiac arrhythmic death and one death from hyperperfusion-related intracerebral hemorrhage. There were no major embolic strokes. CONCLUSIONS: Carotid artery stenting with filter protection is technically feasible and safe. Early clinical outcomes appear to be favorable and need to be confirmed in a larger comparative study.

AB - OBJECTIVES: The aim of this study was to evaluate the feasibility and safety of carotid artery stenting (CAS) with a filter protection system. BACKGROUND: Neurologic events linked to the embolization of particulate matter to the cerebral circulation may complicate CAS. Strategies designed to capture embolic particles during carotid intervention are being evaluated for their efficacy in reducing the risk of these events. METHODS: Between September 1999 and July 2001, a total of 162 patients (164 hemispheres) underwent CAS with filter protection (NeuroShield, MedNova Ltd., Galway, Ireland) according to prospective protocols evaluating the filter system at three institutions. RESULTS: Angiographic success was achieved in 162 of the procedures (99%) and filter placement was successful in 154 (94%) procedures. Carotid access was unsuccessful in two cases (1%) and filter placement in eight cases (5%). Of the latter, five procedures were completed with no protection and three were completed using alternative protection devices. On an intention-to-treat basis, the overall combined 30-day rate of all-stroke and death was 2% (four events: two minor strokes and two deaths). This includes one minor stroke in a patient with failed filter placement and CAS completed without protection. There was one cardiac arrhythmic death and one death from hyperperfusion-related intracerebral hemorrhage. There were no major embolic strokes. CONCLUSIONS: Carotid artery stenting with filter protection is technically feasible and safe. Early clinical outcomes appear to be favorable and need to be confirmed in a larger comparative study.

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