The history of proximal carotid protection and flow reversal to prevent stent angioplasty embolization

Abstract Innovation in medicine is often driven by the observations of imaginative physicians who are blessed with insatiable curiosity, coupled with the inability to accept technical boundaries, the status quo of patient care, or the acceptance of procedural morbidity. Few examples illustrate this...

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Bibliographic Details
Published in:Seminars in vascular surgery 2018-03, Vol.31 (1), p.9-14
Main Authors: Parodi, Juan, Bates, Mark C, Ohki, Takao, Schönholz, Claudio
Format: Article
Language:English
Subjects:
Angioplasty - adverse effects
Angioplasty - instrumentation
Angioplasty - trends
Carotid Artery Diseases - complications
Carotid Artery Diseases - diagnostic imaging
Carotid Artery Diseases - physiopathology
Carotid Artery Diseases - therapy
Cerebrovascular Circulation
Diffusion of Innovation
Embolic Protection Devices - trends
Humans
Intracranial Embolism - diagnostic imaging
Intracranial Embolism - etiology
Intracranial Embolism - physiopathology
Intracranial Embolism - prevention & control
Prosthesis Design
Protective Factors
Regional Blood Flow
Risk Factors
Stents - trends
Stroke - diagnostic imaging
Stroke - etiology
Stroke - physiopathology
Stroke - prevention & control
Surgery
Treatment Outcome
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Summary:Abstract Innovation in medicine is often driven by the observations of imaginative physicians who are blessed with insatiable curiosity, coupled with the inability to accept technical boundaries, the status quo of patient care, or the acceptance of procedural morbidity. Few examples illustrate this truism better than the physician-originated clinical research that transformed the safety of carotid stent angioplasty over the last 2 decades. Initial clinical application of carotid stenting suggested that proximal protection may be a better approach to prevent embolic stroke during the angioplasty procedure. The history of how this innovation was developed is particularly relevant as vascular surgeons adopt new endovascular therapies. It has been more than 15 years since Dr Juan Parodi put together a multidisciplinary team of scientists and clinicians to test the “proximal protection” hypothesis. The goal of this overview was to provide Dr Parodi team's perspective on the development of the proximal protection and flow reversal concept to minimize plaque embolization during carotid stent angioplasty procedures.
ISSN:0895-7967
1558-4518
DOI:10.1053/j.semvascsurg.2018.03.002