Comparison of embolization protection device-specific technical difficulties during carotid artery stenting

Abstract

During CAS, both balloon occlusion and filter devices provide acceptable results and appear complimentary. Filters can be used preferentially to avoid a 10% incidence of reversible neurologic compromise associated with balloon occlusion, except in critically narrowed or tortuous lesions when balloon occlusion may be preferred because of a 12% need for unprotected predilatation with filters.

2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS Guideline on the Management of Patients With Extracranial Carotid and Vertebral Artery Disease: Executive summary

“…[245][246][247][248][249][250][251] If properly deployed, an EPD can reduce the neurological risks associated with CAS, but these devices may also be associated with failures. 53,196,198,247,[252][253][254][255][256][257][258] Among the general risks is access-site injury, which complicates 5% of cases, but most such injuries involve pain and hematoma formation and are self-limited. [259][260][261][262] Contrast-induced nephropathy has been reported in <1% of cases, because CAS is generally avoided in patients with severe renal dysfunction.…”

Observation of the embolus protection filter for carotid artery stenting

“…Distal embolism is always a feared complication during endovascular procedures in carotid arteries (2,10,16). This high propensity for embolic plaque debris led to the development of distal protection techniques to be used during endovascular procedures performed for lesions of the carotid bifurcation (12,13,15).…”

Probable Blood-Brain Barrier Disruption After Carotid Artery Stenting -Case Report-

“…A comparative study of balloon and filter embolic protection devices during CAS found transient neurologic compromise occurred in 10% of the balloon group and identified no anatomic-specific predictors of balloon occlusion intolerance. 8) In another study of cerebral ischemia with PercuSurge balloon occlusion during CAS, an incomplete circle of Willis or contralateral carotid artery occlusion, or both, was present in 8 of 10 patients in whom neurologic intolerance developed during occlusion of carotid artery. 1) In other words, however, 2 of 10 patient developed transient neurologic symptoms with PercuSurge balloon occlusion during CAS in spite of their expected sufficient collateral circulation.…”