Transcranial Doppler Monitoring during Stenting of the Carotid Bifurcation: Evaluation of Two Different Distal Protection Devices in Preventing Embolization

• Published in: Journal of endovascular therapy 2006-08, Vol.13 (4), p.436-442
• Main Authors: Rubartelli, Paolo, Brusa, Giulia, Arrigo, Alessandro, Abbadessa, Francesco, Giachero, Corinna, Vischi, Massimo, Ricca, Maria Maddalena, Ottonello, Gian Andrea
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Angioplasty, Balloon; Carotid Stenosis - diagnostic imaging; Carotid Stenosis - therapy; Cerebrovascular Circulation; Comparative studies; Female; Heart surgery; Humans; Intracranial Embolism - prevention & control; Ischemic Attack, Transient - prevention & control; Male; Middle Aged; Monitoring, Physiologic - methods; Patients; Stents; Treatment Outcome; Ultrasonography, Doppler, Transcranial; Veins & arteries
• ISSN: 1526-6028; 1545-1550
• DOI: 10.1583/05-1804MR.1

Purpose: To compare the efficacy of 2 emboli protection devices in preventing embolization during carotid artery stenting (CAS). Methods: The GuardWire distal occlusion system (n=19) and the distal FilterWire EX (n=12) were compared in 31 consecutive patients (24 men; mean age 71±10 years) monitored with transcranial Doppler for microembolic signals before, during, and after CAS. The choice of the protection device was based on availability and on the patency of the contralateral carotid artery. Results: The baseline characteristics were similar in the patients treated under protection from either device. Placement and retrieval of the protection device, stenting, and postdilation were technically successful in all patients. Two patients suffered a transient ischemic attack shortly after the procedure; no other adverse cardiovascular events occurred at 30 days. Compared to the GuardWire, the use of the FilterWire was associated with more microembolic signals during stent deployment (77.4±33.5 versus 1.07±1.94, p