Balloon-Protected Carotid Artery Stenting

• Thilo Tübler

  From the Center for Cardiology and Vascular Intervention (T.T., M.S., J.S.), Hamburg; the Department of Pathology (O.D.), University Hospital, Essen; the Cardiovascular Center Bethanien (H.S., I.B.), Frankfurt; the Heart Center Siegburg (E.G.), Siegburg; and Franz Volhard Clinic, Humboldt University (J.W.), Berlin, Germany.

• Michael Schlüter

  From the Center for Cardiology and Vascular Intervention (T.T., M.S., J.S.), Hamburg; the Department of Pathology (O.D.), University Hospital, Essen; the Cardiovascular Center Bethanien (H.S., I.B.), Frankfurt; the Heart Center Siegburg (E.G.), Siegburg; and Franz Volhard Clinic, Humboldt University (J.W.), Berlin, Germany.

• Olaf Dirsch

  From the Center for Cardiology and Vascular Intervention (T.T., M.S., J.S.), Hamburg; the Department of Pathology (O.D.), University Hospital, Essen; the Cardiovascular Center Bethanien (H.S., I.B.), Frankfurt; the Heart Center Siegburg (E.G.), Siegburg; and Franz Volhard Clinic, Humboldt University (J.W.), Berlin, Germany.

• Horst Sievert

  From the Center for Cardiology and Vascular Intervention (T.T., M.S., J.S.), Hamburg; the Department of Pathology (O.D.), University Hospital, Essen; the Cardiovascular Center Bethanien (H.S., I.B.), Frankfurt; the Heart Center Siegburg (E.G.), Siegburg; and Franz Volhard Clinic, Humboldt University (J.W.), Berlin, Germany.

• Ilka Bösenberg

  From the Center for Cardiology and Vascular Intervention (T.T., M.S., J.S.), Hamburg; the Department of Pathology (O.D.), University Hospital, Essen; the Cardiovascular Center Bethanien (H.S., I.B.), Frankfurt; the Heart Center Siegburg (E.G.), Siegburg; and Franz Volhard Clinic, Humboldt University (J.W.), Berlin, Germany.

• Eberhard Grube

  From the Center for Cardiology and Vascular Intervention (T.T., M.S., J.S.), Hamburg; the Department of Pathology (O.D.), University Hospital, Essen; the Cardiovascular Center Bethanien (H.S., I.B.), Frankfurt; the Heart Center Siegburg (E.G.), Siegburg; and Franz Volhard Clinic, Humboldt University (J.W.), Berlin, Germany.

• Jürgen Waigand

  From the Center for Cardiology and Vascular Intervention (T.T., M.S., J.S.), Hamburg; the Department of Pathology (O.D.), University Hospital, Essen; the Cardiovascular Center Bethanien (H.S., I.B.), Frankfurt; the Heart Center Siegburg (E.G.), Siegburg; and Franz Volhard Clinic, Humboldt University (J.W.), Berlin, Germany.

• Joachim Schofer

  From the Center for Cardiology and Vascular Intervention (T.T., M.S., J.S.), Hamburg; the Department of Pathology (O.D.), University Hospital, Essen; the Cardiovascular Center Bethanien (H.S., I.B.), Frankfurt; the Heart Center Siegburg (E.G.), Siegburg; and Franz Volhard Clinic, Humboldt University (J.W.), Berlin, Germany.

書誌事項

タイトル別名

• Relationship of Periprocedural Neurological Complications With the Size of Particulate Debris

抄録

Background Carotid artery stenting (CAS) has been advocated as an alternative to endarterectomy. To prevent cerebral atheroembolism during CAS, distal balloon occlusion of the target artery increasingly is employed during the procedure. A correlation of the size of captured particles with the incidence of periprocedural neurological complications (PNCs) has not been attempted. Methods and Results In a 4-center, phase-1 trial, 54 patients (46 men; age, 69±8 years) underwent 58 CAS procedures using the PercuSurge GuardWire system for distal protection. Aspirated debris was sent for histological/cytological analysis. Stent placement was successful in all cases. Mean balloon occlusion time was 10.4±4.0 minutes (range, 3.0 to 22.0 minutes). Three patients (5.2%) experienced PNCs: 1 prolonged reversible ischemic neurological deficit that resolved in ≤48 hours, 1 stroke, and 1 transient ischemic attack. Relevant particles (those with an area ≥10 000 μm 2 ) were found in 48 aspirates (83%). The median number of particles, their maximum diameter, and their maximum area were all significantly higher in the aspirates obtained during procedures associated with PNCs than in aspirates obtained during procedures not associated with PNCs. However, pronounced overlap in the distributions (PNCs versus no PNCs) of the number and maximum diameter of particles precluded any predictive inferences. In contrast, a maximum particle area >800 000 μm 2 (>0.8 mm 2 ) was associated with a 60% chance of having a PNC. Conclusions Despite balloon protection, PNCs occurred in 5.2% of patients who underwent CAS procedures. The maximum area of aspirated particles seems to be an indicator of increased risk for PNCs.

収録刊行物

• Circulation

  Circulation 104 (23), 2791-2796, 2001-12-04

  Ovid Technologies (Wolters Kluwer Health)

キーワード

• Physiology (medical)
• Cardiology and Cardiovascular Medicine

詳細情報

• CRID: 1364233268179704960
• NII論文ID: 30029738786
• DOI: 10.1161/hc4801.100353
• ISSN: 15244539
• ISSN: 00097322
• ISSN: http://id.crossref.org/issn/00097322
• Web Site: https://www.ahajournals.org/doi/full/10.1161/hc4801.100353
• データソース種別:
  • Crossref
  • CiNii Articles