Wall Apposition Assessment and Performance Comparison of Distal Protection Filters

Abstract

Several complications related to apposition of the filter basket on the vessel wall and device retrieval were detected in all the devices. It is inferred that the adaptability of the filter basket to conform to the vessel cross section at the site of deployment is the primary design variable responsible for distal embolization during CAS with cerebral protection.

Efficiency test of current carotid embolic protection devices

“…The result for the round cross profile is in good accordance with previous studies (1%, 4%, 1%) [6,13,15]. The good capture efficiency might be reasoned by the filter geometry [15].…”

“…There, the amount of particles found behind the system was lower than 10% [4,6]. That might suggest that the wall apposition in the actual test was worse because of higher deformation of the device, reasoned by higher flow rate or higher pressure.…”

“…The amount of volume flow rate was selected considering the mean flow rate in the ICA [9] during the systolic phase. It is higher than the volume flow rate in precedent studies, so the stress on the EPDs is maximal [4,6,13,15]. The higher flow rate results in a higher pressure across the EPD and can be seen as an additional challenge.…”

“…The measurement method of particle recovery differs from those in other studies (microscopic [6] or weighing [13]). The counting of the particles in the particle reservoir before the test and in the inline filter with a particle counter is a validated method.…”

“…While carotid endarterectomy is still the treatment of choice, carotid artery stenting (CAS), as a less invasive method, has become a valuable treatment option [1,6].…”