Stenting and Angioplasty with Protection in Patients at High‐Risk for Endarterectomy: SAPPHIRE Worldwide Registry First 2,001 Patients

Abstract

While the number of physicians performing CAS continues to increase, MAE rates seen in this registry (4.4%) are well within an acceptable range, as was first seen in the SAPPHIRE randomized trial (4.8%). A significant decrease in MAE was seen in patients with anatomic risk compared with physiologic risk factors. The SAPPHIRE Worldwide Registry supports the use of CAS as an alternative to CEA in patients who are at high-risk for surgery due to anatomic risk factors.

Neurological Outcome of Stenting in Carotid Occlusive Diseases

“…In this study the frequency of carotid stenosis is more common in male than female 54% versus 46%, this finding is congruent with Sapphire [10] study in which the prevalence of male is more than female (62%) [16]. De Weerd et al, 2009 [17]found that Prevalence of moderate stenosis increases with age in both men and women, but men at all ages have the higher prevalence estimates.…”

“…With no statically difference between CAS and medically treated group (p>0.05). According to disability as regard MRS at presentation in each group, 8 (26.6%) patients in CAS had MRS 0.22 (73.4) patients had MRS 1-2 and no patients had MRS 3, while in medically treated group 4 (20%) patients had MRS 0, 16 (80%) patients had MRS 1-2 and no patients had MRS 3,with no statically difference between CAS and Medically treated group (p>0.05).As regard NIHSS at presentation, 8 (26.7%) patients in CAS group were normal (NIHSS was 0),7 (23.3%) patients had mild stroke (NIHSS 1-5),15 (50%) patients had moderate stroke (NIHSS 6-15) and no patient had moderate to sever (NIHSS [16][17][18][19][20][21][22][23][24][25] or sever stroke (NIHSS 26-42), while in medically treated group 4 (20%) patients were normal, 7 (35%) patients had mild stroke, 9 (45%) patients had moderate stroke and no patient had moderate to sever or sever stroke. With no statically difference between CAS and medically treated group (p>0.05).…”

Safety and efficacy of endovascular treatment for carotid artery stenoses using proximal protection systems: 30-day follow-up

“…Most of published papers on CAS deal with distal protection systems (DPS) [5][6][7][8][9]. Still, it is believed that proximal protection systems (PPS) in terms of their safety and efficacy have potential advantage over distal ones, yet evidence of such superiority remains to be documented [10][11][12][13].…”

Clinical effects and safety review of self-expanding stent surgery for extracranial carotid artery stenosis treatment

“…A number of large-scale, multi-centered, randomized clinically controlled trials have shown that among patients with symptomatic moderate carotid stenosis and asymptomatic severe stenosis, pure drug treatment was generally unsatisfactory in the latter patients, and that carotid endarterectomy (CEA), the standard surgery for carotid stenosis, would likely be more effective (Anonymous, 1991;Boules et al, 2005;Frego et al, 2009;Ederle et al, 2010;Plummer et al, 2011). In recent years, along with the developments of nerve interventional techniques and interventional materials science, the intervention of a percutaneous intravascular stent has become a research focus for the treatment of carotid artery stenosis, which has yielded very good results (Massop et al, 2009;Kan et al, 2012;Shobha et al, 2012). Although some studies have shown that carotid stent angioplasty may result in some complications, even severe complications, most researchers have suggested that the carotid stenting results are even better than CEA results (Tallarita et al, 2011;Fokkema et al, 2012;Dumont and Rughani, 2012).…”