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KMID : 0368120080380120659
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Korean Circulation Journal
2008 Volume.38 No. 12 p.659 ~ p.665
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Technical Feasibility and Early Clinical Outcomes Associated With Distal Filter Device Use for All Carotid Stenting Procedures
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Ahn Kye-Taek
Kim Jei
Kim Dae-Hyun
Lee Jae-Hwan
Jang Won-Il
Kim Eun-Mi
Choi Si-Wan
Jung Jin-Ok
Park Hyeong-Seo
Ahn Moon-Sang
Park Jae-Hyeong
Kim Min-Soo
Seong In-Whan
Jung Il-Soon
Kim Kyu-Seub
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Abstract
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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 EZTM, 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.
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KEYWORD
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Protective devices, Stents, Carotid arteries
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