Carotid Artery Stenting Filter May Cut Complications

NEW YORK (Reuters Health) Mar 19 – A filter protection system appears to reduce the incidence of neurological events in patients following carotid artery stenting, researchers report in the March 6th issue of the Journal of the American College of Cardiology.
Dr. Nadim Al-Mubarak, of Lenox Hill Heart and Vascular Institute, New York, and colleagues note that a number of strategies "designed to capture embolic debris released during carotid intervention are currently being evaluated." In particular, the researchers examined use of the NeuroShield (MedNova Ltd.) filter system in 162 patients who underwent coronary artery stenting.

In the 164 hemispheres so treated, angiographic success was achieved in 99% and filters were successfully placed and recovered in 94%. Visible particles were retrieved from 35% of the filters.

Overall, carotid access was unsuccessful in two cases and filter placement in eight. Alternative protection was supplied to three of these patients, and five went without protection.

Within 30 days, one of the patients with no protection had a minor stroke. Altogether, there were no major embolic strokes and the overall combined incidence of stroke and death at 30 days was 2% (two minor strokes and two deaths). This, say the investigators, compares favorably with embolic minor stroke rates from 2% to 5% and major stroke rates of 1% to 1.5% in studies in which distal protection was not used.

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