Proximal protection with the Gore PAES can reduce DWI lesion size in high-grade stenosis during carotid stenting

被引:18
|
作者
Grunwald, Iris Quasar [1 ,2 ]
Reith, Wolfgang [3 ]
Kuhn, Anna Luisa [4 ]
Balami, Joyce S. [5 ]
Karp, Kerstin [6 ]
Fassbender, Klaus [7 ]
Walter, Silke [7 ]
Papanagiotou, Panagiotis [8 ]
Krick, Christoph [3 ]
机构
[1] Anglia Ruskin Univ, PMI, Chelmsford CM1 1SQ, Essex, England
[2] Southend Univ Hosp, Westcliff On Sea, Essex, England
[3] Univ Hosp Saarland, Dept Diagnost & Intervent Neuroradiol, Homburg, Germany
[4] Univ Massachusetts, Dept Radiol, Worcester, MA 01605 USA
[5] John Radcliffe Hosp, Oxford Univ Hosp NHS Trust, Dept Med & Clin Geratol, Acute Stroke Programme, Oxford OX3 9DU, England
[6] Stadt Klinikum Neunkirchen, Neunkirchen, Germany
[7] Univ Hosp Saarland, Dept Neurol, Homburg, Germany
[8] Klinikum Bremen Mitte, Clin Diagnost & Intervent Neuroradiol, Bremen, Germany
关键词
carotid artery stenting; carotid stenosis; cerebral protection; diffusion-weighted imaging; FLOW REVERSAL SYSTEM; RANDOMIZED-TRIAL; CEREBRAL PROTECTION; ENDARTERECTOMY; NEUROPROTECTION; EMBOLIZATION; PREVENTION; ISCHEMIA; DEVICES;
D O I
10.4244/EIJV10I2A45
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aims: The aim was to determine the incidence of new ischaemic lesions on diffusion-weighted MR imaging (DWI) in a non-randomised cohort of patients after protected and unprotected carotid artery stent placement using the Parodi Anti-Emboli System (PAES). Methods and results: A retrospective review was conducted on 269 patients who received DWI prior to, and 24-72 hours after, stent placement. All patients were enrolled in one centre. Forty patients stented with the PAES device were matched with 229 patients stented without protection (control group). New diffusion restriction on DWI was detected in 25.8% (PAES) versus 32.3% (control group); p=0.64. On average there were 0.7 lesions (PAES) versus 0.8 lesions (control group) per patient. The area of lesions was 1.7 (PAES) versus 5.6 mm(2). In a subanalysis of patients (32 PAES, 148 non-protected) with >80% stenosis, the area of restricted diffusion was less when proximal protection was used (p<0.05). The number and area of DWI lesions did not differ on the contralateral, non-stented side. When the PAES system was used, patients were more likely not to have any lesion at all (p=0.028). Conclusions: In high-grade stenosis, the use of the Gore PAES device significantly reduced the area of new DWI lesions and patients were more likely not to have any new DWI lesion at all.
引用
收藏
页码:271 / 276
页数:6
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