Practive And Study Of Carotid Artery Stenting Under Cerebral Protection Devices

Background: Cerebral protection devices are designed to be placed distal to thestenosis and collect the embolic debris before it enters the intracranial circulation. There are now several case series reporting experience of endovascular treatment with cerebral protection. A recent systematic review of the nonrandomized single-center evidence on early outcome after carotid angioplasty and stenting with and without cerebral protection devices found that the use of cerebral protection devices appears to reduce the risk of thromboembolic complications during endovascular treatment. However, there is as yet no evidence from completed randomized trials comparing stenting with or without cerebral protection.Objectives: To explore the safety and efficacy of carotid angioplastyandstenting:(CAS) with cerebral protection devices for carotid stenosis.Methods : Seventy-four patients with carotid stenosis were treated with CAS with(n =21) or without (n=53)cerebral protection devices. All of them took periprocedual anticoagulation treatment, cerebral vascular angiograpgy. Cerebral thromboembolic events were noted and the filter devices were observed. All patients were followed - up for short -term. The clinical results were summarized, and the indispensability and feasibility were discussed.Results: seventy-six self-expandable stents were deployed in 74 patients withcarotid stenosis. The lesions in the group without cerebral protection devices were predilated 20 times(37.7%)with the balloons, and all were postdilated. the lesions in the group with cerebral protection devices were predilated 6 times(28.5%)with balloons, and all were postdilated. Fifteen patients(20.2% ) had transient bradycardia and hypotension during the CAS treatment, one patient in the group with cerebral protection devices had cerebral infarction (4.7% )during the perioperative period, Four patients in the group without cerebral protection devices had cerebral infarction (7.5% )during the perioperative period. (p>0.05) .one patient in the group with cerebral protection devices had cerebral infarction (4.7 %) during the follow up, Five patients in the group without cerebral protection devices had cerebral infarction (9.4 %)during the follow up .(p>0.05).Conclusions: Cerebral protection devices are not helpful to reduce the neurological complications in patients with carotid stenosis during CAS.