pISSN 1738-5520 eISSN 1738-5555
Indexed in PubMed, SCIE and Scopus
Open Access, Peer-reviewed, Monthly
    Korean Circ J. 2008 Dec;38(12):659-665. Korean.
    Published online Dec 31, 2008.
    https://doi.org/10.4070/kcj.2008.38.12.659
    Copyright © 2008 The Korean Society of Cardiology
    Original Article

    Technical Feasibility and Early Clinical Outcomes Associated With Distal Filter Device Use for All Carotid Stenting Procedures

    Kye-Taek Ahn, MD,1 Jae-Hwan Lee, MD,1 Dae-Hyun Kim, MD,2 Jei Kim, MD,2 Moon Sang Ahn, MD,3 Jae-Hyeong Park, MD,1 Hyeong-Seo Park, MD,1 Eun-Mi Kim, MD,1 Won-Il Jang, MD,1 Min-Soo Kim, MD,1 Il-Soon Jung, MD,1 Kyu-Seub Kim, MD,1 Si Wan Choi, MD,1 Jin-Ok Jeong, MD,1 and In-Whan Seong, MD1
      • 1Division of Cardiology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea.
      • 2Department of Neurology, Chungnam National University School of Medicine, Daejeon, Korea.
      • 3Department of Surgery, Chungnam National University School of Medicine, Daejeon, Korea.
    • Correspondence: Jae-Hwan Lee, MD, Division of Cardiology, Department of Internal Medicine, Chungnam National University School of Medicine, 33 Munhwa-ro, Jung-gu, Daejeon 301-721, Korea. Tel: 82-42-280-8237, Fax: 82-42-280-8238, Email: myheart@cnu.ac.kr
    Received August 19, 2008; Accepted September 23, 2008.

    Abstract

    Background and Objectives

    Distal filter devices (DFDs) are known to reduce the occurrence of embolic events by capturing embolic debris and thereby preventing intracranial embolization during carotid artery stenting (CAS). However, there are few reports addressing DFD use in CAS procedures. Therefore, we evaluated the technical feasibility and clinical outcomes associated with DFD use in all CAS procedures.

    Subjects and Methods

    Between June 2004 and June 2008, all CAS procedures performed at our center were completed with DFD protection. We recorded periprocedural data and watched for new neurologic abnormalities for 24 hours after the procedure. One-month clinical outcomes were also evaluated.

    Results

    A total of 100 carotid lesions in 94 patients (age 68±8 years; 79 men) were treated with percutaneous stenting using DFDs (FilterWire EZ™, Boston Scientific Co, US). DFD application was successful in all procedures. Periprocedural strokes occurred in five procedures (one major, one minor, and three transient ischemic attacks). The one-month rates of stroke and death were 6% and 2%, respectively. Difficult filter placement occurred in two procedures due to tight stenosis and severe common carotid artery (CCA)-to-internal carotid artery (ICA) angulation. Difficult stent delivery occurred in three instances: one due to severe lesion calcification and two due to proximal tortuosity. The retriever failed to acquire the filter in nine procedures. Four of nine retrieval difficulties were related to severe CCA-ICA angulation.

    Conclusion

    DFD use was successful in all CAS procedures, was relatively safe, and had few periprocedural complications.

    Keywords
    Protective devices; Stents; Carotid arteries

    Tables

    Table 1
    Baseline clinical characteristics

    Table 2
    Carotid lesion characteristics

    Table 3
    Procedural characteristics

    Table 4
    Periprocedural and one month clinical outcome

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    MeSH Terms
    Boston
    Carotid Arteries
    Carotid Artery, Common
    Constriction, Pathologic
    Dapsone
    Humans
    Protective Devices
    Stents
    Stroke
    Metrics
    Share
    Tables
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