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THE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica


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The Journal of Cardiovascular Surgery 2002 June;43(3):391-7

Copyright © 2009 EDIZIONI MINERVA MEDICA

lingua: Inglese

Prospective comparative study of two cerebral protection devices in carotid angioplasty and stenting

Grego F., Frigatti P., Amistà P., Lepidi S., Antonello M., Carollo C., Deriu G. P.

From the Division of Vascular Surgery Department of Medical and Surgical Sciences University of Padua Medical School *Division of Neuroradiology, Padua Hospital, Padua, Italy


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Background. The ­aim of ­the ­study ­was to com­pare ­two of ­the avail­able cere­bral pro­tec­tion devic­es (­CPD) PercuSurge, bal­loon ­type (­group A) ­and Angioguard, fil­ter ­type (­group B) ­used in carot­id stent­ing ­and angio­plas­ty (­CAS).
Methods. From September 1999 to February 2001, 26 con­sec­u­tive ­patients under­go­ing ­CAS ­were alter­na­tive­ly ­assigned to ­group A ­and B. Postoperative dis­abling ­stroke ­and neu­ro­log­i­cal mor­tal­ity, non­dis­abling ­stroke, ­TIA ­and non­-neu­ro­log­i­cal mor­tal­ity ­were exam­ined. ­CPD fea­tures includ­ed ­time ­required, ­ease of han­dling, ­device rup­ture or mal­func­tion­ing, radio­paque mark­ers evi­dence, abnor­mal ­major mobil­ity of ­the ­opened ­system.
Results. ­RNCR ­was 0 ­and TIAs ­were ­not ­observed in ­either ­group. Four ­patients (3 in ­group A ­and 1 in ­group B) ­showed drow­si­ness in ­the imme­di­ate post­op­er­a­tive peri­od. Perioperative carot­id occlu­sion ­and sur­gi­cal con­ver­sion ­were ­observed in 1 ­case of ­group A. Average ­time cal­cu­lat­ed ­from ­the begin­ning of ­set-up to com­plete remov­al ­was 46 ­min in ­group A ver­sus 31 ­min in ­group B. Abnormal ­major mobil­ity of ­the ­opened ­system ­was ­very ­often ­observed dur­ing endo­vas­cu­lar maneu­vers ­with ­both devic­es.
Conclusions. ­CAS ­may pro­tect ­against post­op­er­a­tive pro­ce­dure-relat­ed neu­ro­log­i­cal ­events. Common ­and spe­cif­ic dis­ad­van­tag­es ­were ­observed in ­both ­systems show­ing ­they ­were ­not ­close ­enough to ­the ­ideal ­device.

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