Transcervical Carotid Stenting With Dynamic Flow Reversal Demonstrates Embolization Rates Comparable to Carotid Endarterectomy

Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists
Maarten PlessersFrank Vermassen

Abstract

To evaluate a series of patients treated electively with carotid endarterectomy (CEA), transfemoral carotid artery stenting with distal filter protection (CASdp), and transcervical carotid stenting with dynamic flow reversal (CASfr) monitored continuously with transcranial Doppler (TCD) during the procedure to detect intraoperative embolization rates. Thirty-four patients (mean age 67.6 years; 24 men) with significant carotid stenosis underwent successful TCD monitoring during the revascularization procedure (10 CEA, 8 CASdp, and 16 CASfr). Ipsilateral microembolic signals were segregated into 3 phases: preprotection (until internal carotid artery cross-shunted or clamped if no shunt was used, filter deployed, or flow reversal established), protection (until clamp/shunt was removed, filter retrieved, or antegrade flow reestablished), and postprotection (after clamp/shunt or filter removal or restoration of normal flow). CASdp showed higher embolization rates than CEA or CASfr in the preprotection phase (p<0.001). In the protection phase, CASdp was again associated with more embolization compared with CEA and CASfr (p<0.001). In the postprotection phase, no differences between the revascularization therapies were observed. CASfr...Continue Reading

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Citations

Aug 16, 2016·International Journal of Cardiology·Kosmas I Paraskevas, Frank J Veith
Mar 18, 2016·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Kosmas I ParaskevasJuan C Parodi
Oct 14, 2016·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Piotr Musialek, Silke Hopf-Jensen
Dec 6, 2018·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Luca GarriboliAntonio Maria Jannello
Mar 2, 2019·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Kosmas I ParaskevasMarc L Schermerhorn
Mar 2, 2019·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Pavlos TexakalidisJohn Reavey-Cantwell
Mar 9, 2019·The Journal of Cardiovascular Surgery·Patric LiangMarc L Schermerhorn
Aug 6, 2019·Circulation. Cardiovascular Interventions·Mandy D MüllerLeo H Bonati
Mar 25, 2017·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Juan ParodiClaudio Schönholz
Aug 20, 2020·Stroke; a Journal of Cerebral Circulation·Andreia CoelhoGert J de Borst
Mar 25, 2017·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Alper AlpaslanRalf Kolvenbach
May 26, 2017·Vascular and Endovascular Surgery·Lauren A HuntressSaum A Rahimi
Jun 17, 2020·International Angiology : a Journal of the International Union of Angiology·Petroula N NanaAthanasios D Giannoukas
Sep 9, 2019·Journal of Vascular Surgery·Joseph SabatWei Zhou
Feb 15, 2020·Journal of the American College of Cardiology·Joshua A BeckmanTony S Das
Mar 7, 2021·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·George C GalyfosVassilios Papavassiliou
Oct 11, 2020·Journal of Vascular Surgery·Christina L CuiMahmoud B Malas
Apr 18, 2021·Journal of Vascular Surgery·Marios SagrisChristos Bakoyiannis
Aug 21, 2021·European Stroke Journal·Leo H BonatiHans-Henning Eckstein

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Methods Mentioned

BETA
dissection

Software Mentioned

MATLAB
SPSS
CASdp

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