Safety of Carotid Stenting – a Comparison of Protection Systems

Česká verzia

Authors: O. Pavlík ¹; D. Václavík ¹; D. Kučera ²; J. Návratová ³; G. Solná ¹; M. Rabasová ⁴
Authors place of work: Vzdělávací a výzkumný institut Agel, Neurologické oddělení, Vítkovická nemocnice a. s., Ostrava ¹; Vaskulární centrum, Vítkovická nemocnice a. s., Ostrava ²; Radiologické oddělení, Vítkovická nemocnice a. s., Ostrava ³; Katedra matematiky a deskriptivní geometrie, VŠB – Technická univerzita Ostrava ⁴
Published in the journal: Cesk Slov Neurol N 2016; 79/112(5): 560-564
Category: Original Paper

Summary

Aim:
To compare safety and efficacy of distal protection devices (filters) and the proximal protection device (Mo.Ma system) during carotid artery stenting (CAS) and to prove or reject lower incidence of new microembolic lesions with Mo.Ma protection. To determine the impact of microembolic lesions after CAS on cognitive functions.

Methods:
Fifty-six patients were randomized into two groups according to the cerebral protection used (Filter vs. Mo.Ma group). All patients underwent brain magnetic resonance imaging (MRI) before and after stenting. Thirty-two patients were tested before and 30 days after stenting with Adenbrook Cognitive Examination revised (ACE-R) tests.

Results:
32.14% (n = 18) of all patients had new ischemic lesions on MRI after CAS, 32.43% (n = 12) of the Filter group patients (n = 37) and 31.58% (n = 6) of the Mo.Ma group patients (n = 19). Only 38.89% of all new ischemic lesions were located solely in the territory of the treated artery, 16.67% in the Filter group (p = 0.006) and 83.33% in the Mo.Ma group (p = 0.037). Significant decline in ACE-R test was found in one patient only.

Conclusion:
New ischemic lesions after CAS were present on MRI in both groups with no significant difference. Significantly more lesions were located outside the territory of the treated artery in the Filter group and inside the territory in the Mo.Ma group. We did not prove negative impact of new lesions on the ACE-R tests results.

Key words:
carotid stenosis – embolic protection devices – magnetic resonance imaging – cognitive function

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

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