Multicenter evaluation of carotid artery stenting with a filter protection system
Key result
Filter-protected carotid artery stenting yields a 2% 30-day stroke and death rate.
- n=162
Why the study?
Neurologic events from embolization during carotid artery stenting may complicate the procedure, and strategies to capture embolic particles are being evaluated for efficacy in reducing these events.
Is carotid artery stenting with a filter protection system feasible and safe in patients requiring carotid intervention?
Population
162 patients (164 hemispheres) undergoing carotid artery stenting
Comparison
Carotid artery stenting with filter protection system
Design
Prospective multicenter evaluation at three institutions
Follow-up
30-day
Authors
Discussion
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Member takes
Implication
Supports filter-protected carotid stenting feasibility in selected patients; leaves open randomized comparisons to endarterectomy or unprotected stenting.
Key Points
- To assess the technical feasibility and safety of carotid artery stenting using a specialized filter protection system to prevent embolic neurologic complications.
- Prospective multicenter evaluation conducted across three institutions between September 1999 and July 2001.
- Enrolled 162 patients (164 hemispheres) undergoing carotid artery stenting with the NeuroShield filter protection system.
- Angiographic success occurred in 162 procedures (99%), and filter placement was successful in 154 procedures (94%), with failed carotid access in 2 cases (1%) and failed filter deployment in 8 cases (5%).
- On an intention-to-treat basis, the combined 30-day rate of all-cause stroke and death was 2% (4 of 164 events: 2 minor strokes and 2 deaths).
- Observed deaths included one cardiac arrhythmia and one hyperperfusion-related intracerebral hemorrhage, with zero major embolic strokes recorded.
Study Design
Type
Observational (n=162)
Multicenter
Yes
Structured PICO
Is carotid artery stenting with a filter protection system feasible and safe in patients requiring carotid intervention?
P
Population
162 patients undergoing carotid artery stenting with a filter protection system, evaluated for 30-day outcomes.
E
Exposure
Carotid artery stenting with a filter protection system
O
Outcome
Feasibility (angiographic success and filter placement success) and safety (combined 30-day rate of all-stroke and death)safety
The use of a filter protection system during carotid artery stenting is technically feasible with a high success rate and a low 30-day rate of stroke and death.
Limitations
- Early clinical outcomes need to be confirmed in a larger comparative study
- Needs to be confirmed in a larger comparative study
Cite This Study
Al‐Mubarak et al. (2002) conducted an observational in Carotid artery disease (n=162). Carotid artery stenting with filter protection was evaluated on overall combined 30-day rate of all-stroke and death. Carotid artery stenting with filter protection was technically feasible, with a 99% angiographic success rate and a 2% combined 30-day rate of all-stroke and death.