Protected carotid stenting in high-surgical-risk patients: The ARCHeR results

Gray, William A.; Hopkins, L. Nelson; Yadav, Sanjay; Davis, Thomas P.; Wholey, Mark H.; Atkinson, Richard; Cremonesi, Alberto; Fairman, Ronald M.; Walker, Gary; Verta, Patrick; Popma, J.J.; Virmani, Renu; Cohen, David J.

doi:10.1016/j.jvs.2006.03.044

Cited by 388 publications

(275 citation statements)

References 34 publications

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“…The risk of MI is generally reported as approximately 1% but reached 2.4% in the ARCHeR (ACCULINK for Revascularization of Carotids in High-Risk Patients) trial and was as low as 0.9% in the CAPTURE (Carotid ACCULINK/ACCU-NET Post-Approval Trial to Uncover Unanticipated or Rare Events) registry of 3,500 patients. 42,181,[187][188][189][190][191][192][193][194][195][196] The risk of arterial dissection or thrombosis in all published series was <1%. Target-vessel perforation occurred in <1% of cases, and external carotid artery stenosis or occlusion occurred in 5% to 10%, 42,53,181, but this event is typically benign, requiring no further intervention.…”

Section: Carotid Artery Stentingmentioning

confidence: 99%

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

Brott

Halperin

Abbara

et al. 2011

Cathet Cardio Intervent

185

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Section: Carotid Artery Stentingmentioning

confidence: 99%

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

Brott

Halperin

Abbara

et al. 2011

Cathet Cardio Intervent

185

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“…Não houve AVC hemorrágico nesse grupo. A incidência entre 30 dias e 1 ano de AVC ipsilateral foi de 1,3% 11 . Dois estudos publicados recentemente, o EVA-3S 12 e o SPACE 13 , não conseguiram demonstrar não inferioridade dos resultados do tratamento endovascular em relação à endarterectomia.…”

Section: O Sapphi-re (Stenting With Protection In Patients At High Riunclassified

Estudo prospectivo comparativo entre a endarterectomia e a angioplastia com stent e proteção cerebral no tratamento das lesões ateroscleróticas carotídeas: resultados em 30 dias

Tinoco¹,

Silva

Luquini³

et al. 2006

J. vasc. bras.

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257 ResumoObjetivo: Analisar comparativamente os resultados, em 30 dias, entre a endarterectomia e a angioplastia com stent auto-expansível e filtro de proteção cerebral, avaliando a incidência de acidente vascular cerebral e óbito, bem como o tempo de permanência hospitalar no tratamento das lesões ateroscleróticas da bifurcação carotídea.Método: Estudo prospectivo, em que foram tratados 80 pacientes, sintomáticos e assintomáticos, com lesões estenóticas maiores que 60 e 70%, respectivamente, da bifurcação carotídea. Os pacientes foram divididos em dois grupos de 40 pacientes, que foram avaliados quanto a sexo, idade, comorbidades associadas e tabagismo.Resultados: A taxa de acidente vascular cerebral e óbito foi de 5,0% em ambas as técnicas. Ocorreu um caso (2,5%) de ataque isquêmico transitório no grupo endovascular e nenhum na endarterectomia. No que se refere ao tempo de internação, o tratamento endovascular apresentou menor tempo em relação à endarterectomia, sendo estatisticamente significativo (P < 0,002).Conclusões: Nesta série apresentada, a incidência de acidente vascular cerebral e óbito em 30 dias foi de 5% nas duas técnicas utilizadas. Em relação ao tempo de internação, houve um menor tempo de permanência hospitalar a favor da técnica endovascular, com significância estatística (P < 0,002).Palavras chaves: Carótida, endarterectomia, angioplastia. AbstractObjective: To comparatively analyze the 30-day results between endarterectomy and angioplasty using self-expandable stent and filter protection in the treatment of carotid bifurcation atherosclerotic lesions. The primary endpoint was to analyze stroke and death rate, as well hospitalization time.Methods: Comparative and prospective study in 80 symptomatic and asymptomatic patients, with carotid bifurcation stenotic lesions greater than 60 and 70%, respectively. The patients were divided into two groups of 40 and assessed according to gender, age, associated comorbid conditions and smoking.Results: The stroke and death rate was 5.0% for both techniques. There was only one case of transient ischemic attack (2.5%) in the endovascular group. Regarding hospitalization time, it was significantly lower in favor of the endovascular technique, with statistical significance (P < 0.002).Conclusions: This study demonstrated a 5.0% incidence of stroke and death in 30 days considering both techniques. However, the endovascular group presented a statistically significant shorter hospitalization time than the endarterectomy group (P < 0.002). Keywords IntroduçãoO acidente vascular cerebral (AVC) isquêmico é a causa mais comum de déficit neurológico na população idosa, e a doença cerebral de origem extracraniana é responsável por aproximadamente 20-30% dos casos. A aterosclerose obliterante é o principal fator etiológico dessas lesões.A endarterectomia carotídea (EC), ao longo do tempo, apresenta-se como o principal método terapêu-tico no tratamento e prevenção desses acidentes encefá-

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“…According to other authors, 7 our exclusion criteria for CEA are as follows: severe pulmonary and/or cardiac conditions, contralateral laryngel nerve palsy, previous neck surgery or radiotherapy, high or low bifurcation, or plaque extension. CAS was then planned as alternative strategy.…”

Section: Case Reportmentioning

confidence: 99%

Preoperative and Postoperative Evaluation of New Double Mesh Carotid Stents with Contrast-Enhanced Ultrasound and Diffusion-Weighted Imaging

Castagno

Varetto

Sperti

et al. 2016

Annals of Vascular Surgery

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Protected carotid stenting in high-surgical-risk patients: The ARCHeR results

Abstract: The ARCHeR results demonstrate that extracranial carotid artery stenting with embolic filter protection is not inferior to historical results of endarterectomy and suggest that carotid artery stenting is a safe, durable, and effective alternative in high-surgical-risk patients.

Cited by 388 publications

References 34 publications

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

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

Estudo prospectivo comparativo entre a endarterectomia e a angioplastia com stent e proteção cerebral no tratamento das lesões ateroscleróticas carotídeas: resultados em 30 dias

Preoperative and Postoperative Evaluation of New Double Mesh Carotid Stents with Contrast-Enhanced Ultrasound and Diffusion-Weighted Imaging

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