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Transcranial Doppler Monitoring during Stenting of the Carotid Bifurcation: Evaluation of Two Different Distal Protection Devices in Preventing Embolization
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...
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| Published in: | Journal of endovascular therapy 2006-08, Vol.13 (4), p.436-442 |
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| Main Authors: | , , , , , , , |
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| cited_by | cdi_FETCH-LOGICAL-c328t-bb1122ff197f8cfa61084980945944e42b0afec5f5738c101e097fbd7a25281f3 |
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| cites | cdi_FETCH-LOGICAL-c328t-bb1122ff197f8cfa61084980945944e42b0afec5f5738c101e097fbd7a25281f3 |
| container_end_page | 442 |
| container_issue | 4 |
| container_start_page | 436 |
| container_title | Journal of endovascular therapy |
| container_volume | 13 |
| creator | Rubartelli, Paolo Brusa, Giulia Arrigo, Alessandro Abbadessa, Francesco Giachero, Corinna Vischi, Massimo Ricca, Maria Maddalena Ottonello, Gian Andrea |
| description | 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 |
| doi_str_mv | 10.1583/05-1804MR.1 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_68780216</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1583_05-1804MR.1</sage_id><sourcerecordid>1124782151</sourcerecordid><originalsourceid>FETCH-LOGICAL-c328t-bb1122ff197f8cfa61084980945944e42b0afec5f5738c101e097fbd7a25281f3</originalsourceid><addsrcrecordid>eNptkU9rGzEQxUVpaP711HsRPZRA2FQjr9ba3FrbbQIJKa17Flp5lCqsV66kdUg-Sz5stLYhEHrRPInfvBFvCPkA7AyEHH1hogDJyutfZ_CGHIAo810I9nbQvCoqxuU-OYzxjjEOHOAd2Yeq5hJEdUCe5kF30eTD6ZZO_WrVYqDXvnPJB9fd0kW_Kb8TdmkQ3tL0F-lEB5_cgn5ztg9GJ-e7czpb67bf6AGb33s6ddZiyK1ZxZQn_MxtaDbIFNfOYKSuy6-43vnPlo1v3ePG5ZjsWd1GfL-rR-TP99l8clFc3fy4nHy9KsyIy1Q0DQDn1kI9ttJYXQGTZS1ZXYq6LLHkDdMWjbBiPJIGGCDLZLMYay5yDHZ0RD5vfVfB_-sxJrV00WDb6g59H1UlxzJnV2Xw0yvwzvehy39TOVhgtawH6HQLmeBjDGjVKrilDg8KmBo2pphQ240pyPTHnWXfLHHxwu5WlIGTLRD1Lb7M-5_XM1rPn3w</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>211109896</pqid></control><display><type>article</type><title>Transcranial Doppler Monitoring during Stenting of the Carotid Bifurcation: Evaluation of Two Different Distal Protection Devices in Preventing Embolization</title><source>SAGE</source><creator>Rubartelli, Paolo ; Brusa, Giulia ; Arrigo, Alessandro ; Abbadessa, Francesco ; Giachero, Corinna ; Vischi, Massimo ; Ricca, Maria Maddalena ; Ottonello, Gian Andrea</creator><creatorcontrib>Rubartelli, Paolo ; Brusa, Giulia ; Arrigo, Alessandro ; Abbadessa, Francesco ; Giachero, Corinna ; Vischi, Massimo ; Ricca, Maria Maddalena ; Ottonello, Gian Andrea</creatorcontrib><description>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<0.0001), postdilation (63.9±21.0 versus 2.06±2.58, p<0.0001), and retrieval of the protection device (21.4±15.4 versus 10.9±8.3, p=0.051). Consequently, the total amount of microembolic signals during the procedure was higher when the filter device was employed (183.0±42.1 versus 31.7±12.0, p<0.0001).
Conclusion:
The distal occlusion device appears to be more effective than the filter in reducing distal embolization detected by transcranial Doppler monitoring.</description><identifier>ISSN: 1526-6028</identifier><identifier>EISSN: 1545-1550</identifier><identifier>DOI: 10.1583/05-1804MR.1</identifier><identifier>PMID: 16928156</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>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</subject><ispartof>Journal of endovascular therapy, 2006-08, Vol.13 (4), p.436-442</ispartof><rights>2006 SAGE Publications</rights><rights>Copyright Alliance Communications Group, A Division of Allen Press, Inc. Aug 2006</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c328t-bb1122ff197f8cfa61084980945944e42b0afec5f5738c101e097fbd7a25281f3</citedby><cites>FETCH-LOGICAL-c328t-bb1122ff197f8cfa61084980945944e42b0afec5f5738c101e097fbd7a25281f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904,79110</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16928156$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rubartelli, Paolo</creatorcontrib><creatorcontrib>Brusa, Giulia</creatorcontrib><creatorcontrib>Arrigo, Alessandro</creatorcontrib><creatorcontrib>Abbadessa, Francesco</creatorcontrib><creatorcontrib>Giachero, Corinna</creatorcontrib><creatorcontrib>Vischi, Massimo</creatorcontrib><creatorcontrib>Ricca, Maria Maddalena</creatorcontrib><creatorcontrib>Ottonello, Gian Andrea</creatorcontrib><title>Transcranial Doppler Monitoring during Stenting of the Carotid Bifurcation: Evaluation of Two Different Distal Protection Devices in Preventing Embolization</title><title>Journal of endovascular therapy</title><addtitle>J Endovasc Ther</addtitle><description>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<0.0001), postdilation (63.9±21.0 versus 2.06±2.58, p<0.0001), and retrieval of the protection device (21.4±15.4 versus 10.9±8.3, p=0.051). Consequently, the total amount of microembolic signals during the procedure was higher when the filter device was employed (183.0±42.1 versus 31.7±12.0, p<0.0001).
Conclusion:
The distal occlusion device appears to be more effective than the filter in reducing distal embolization detected by transcranial Doppler monitoring.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Angioplasty, Balloon</subject><subject>Carotid Stenosis - diagnostic imaging</subject><subject>Carotid Stenosis - therapy</subject><subject>Cerebrovascular Circulation</subject><subject>Comparative studies</subject><subject>Female</subject><subject>Heart surgery</subject><subject>Humans</subject><subject>Intracranial Embolism - prevention & control</subject><subject>Ischemic Attack, Transient - prevention & control</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Monitoring, Physiologic - methods</subject><subject>Patients</subject><subject>Stents</subject><subject>Treatment Outcome</subject><subject>Ultrasonography, Doppler, Transcranial</subject><subject>Veins & arteries</subject><issn>1526-6028</issn><issn>1545-1550</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><recordid>eNptkU9rGzEQxUVpaP711HsRPZRA2FQjr9ba3FrbbQIJKa17Flp5lCqsV66kdUg-Sz5stLYhEHrRPInfvBFvCPkA7AyEHH1hogDJyutfZ_CGHIAo810I9nbQvCoqxuU-OYzxjjEOHOAd2Yeq5hJEdUCe5kF30eTD6ZZO_WrVYqDXvnPJB9fd0kW_Kb8TdmkQ3tL0F-lEB5_cgn5ztg9GJ-e7czpb67bf6AGb33s6ddZiyK1ZxZQn_MxtaDbIFNfOYKSuy6-43vnPlo1v3ePG5ZjsWd1GfL-rR-TP99l8clFc3fy4nHy9KsyIy1Q0DQDn1kI9ttJYXQGTZS1ZXYq6LLHkDdMWjbBiPJIGGCDLZLMYay5yDHZ0RD5vfVfB_-sxJrV00WDb6g59H1UlxzJnV2Xw0yvwzvehy39TOVhgtawH6HQLmeBjDGjVKrilDg8KmBo2pphQ240pyPTHnWXfLHHxwu5WlIGTLRD1Lb7M-5_XM1rPn3w</recordid><startdate>200608</startdate><enddate>200608</enddate><creator>Rubartelli, Paolo</creator><creator>Brusa, Giulia</creator><creator>Arrigo, Alessandro</creator><creator>Abbadessa, Francesco</creator><creator>Giachero, Corinna</creator><creator>Vischi, Massimo</creator><creator>Ricca, Maria Maddalena</creator><creator>Ottonello, Gian Andrea</creator><general>SAGE Publications</general><general>Allen Press Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>200608</creationdate><title>Transcranial Doppler Monitoring during Stenting of the Carotid Bifurcation: Evaluation of Two Different Distal Protection Devices in Preventing Embolization</title><author>Rubartelli, Paolo ; Brusa, Giulia ; Arrigo, Alessandro ; Abbadessa, Francesco ; Giachero, Corinna ; Vischi, Massimo ; Ricca, Maria Maddalena ; Ottonello, Gian Andrea</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c328t-bb1122ff197f8cfa61084980945944e42b0afec5f5738c101e097fbd7a25281f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Angioplasty, Balloon</topic><topic>Carotid Stenosis - diagnostic imaging</topic><topic>Carotid Stenosis - therapy</topic><topic>Cerebrovascular Circulation</topic><topic>Comparative studies</topic><topic>Female</topic><topic>Heart surgery</topic><topic>Humans</topic><topic>Intracranial Embolism - prevention & control</topic><topic>Ischemic Attack, Transient - prevention & control</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Monitoring, Physiologic - methods</topic><topic>Patients</topic><topic>Stents</topic><topic>Treatment Outcome</topic><topic>Ultrasonography, Doppler, Transcranial</topic><topic>Veins & arteries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rubartelli, Paolo</creatorcontrib><creatorcontrib>Brusa, Giulia</creatorcontrib><creatorcontrib>Arrigo, Alessandro</creatorcontrib><creatorcontrib>Abbadessa, Francesco</creatorcontrib><creatorcontrib>Giachero, Corinna</creatorcontrib><creatorcontrib>Vischi, Massimo</creatorcontrib><creatorcontrib>Ricca, Maria Maddalena</creatorcontrib><creatorcontrib>Ottonello, Gian Andrea</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of endovascular therapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rubartelli, Paolo</au><au>Brusa, Giulia</au><au>Arrigo, Alessandro</au><au>Abbadessa, Francesco</au><au>Giachero, Corinna</au><au>Vischi, Massimo</au><au>Ricca, Maria Maddalena</au><au>Ottonello, Gian Andrea</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Transcranial Doppler Monitoring during Stenting of the Carotid Bifurcation: Evaluation of Two Different Distal Protection Devices in Preventing Embolization</atitle><jtitle>Journal of endovascular therapy</jtitle><addtitle>J Endovasc Ther</addtitle><date>2006-08</date><risdate>2006</risdate><volume>13</volume><issue>4</issue><spage>436</spage><epage>442</epage><pages>436-442</pages><issn>1526-6028</issn><eissn>1545-1550</eissn><abstract>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<0.0001), postdilation (63.9±21.0 versus 2.06±2.58, p<0.0001), and retrieval of the protection device (21.4±15.4 versus 10.9±8.3, p=0.051). Consequently, the total amount of microembolic signals during the procedure was higher when the filter device was employed (183.0±42.1 versus 31.7±12.0, p<0.0001).
Conclusion:
The distal occlusion device appears to be more effective than the filter in reducing distal embolization detected by transcranial Doppler monitoring.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>16928156</pmid><doi>10.1583/05-1804MR.1</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | Journal of endovascular therapy, 2006-08, Vol.13 (4), p.436-442 |
| issn | 1526-6028 1545-1550 |
| language | eng |
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| source | SAGE |
| 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 |
| title | Transcranial Doppler Monitoring during Stenting of the Carotid Bifurcation: Evaluation of Two Different Distal Protection Devices in Preventing Embolization |
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