Journal of Vascular Surgery
Volume 46, Issue 1 , Pages 49-54 , July 2007

Transcervical carotid stenting with flow reversal protection: Experience in high-risk patients

Presented at the Western Vascular Society Meeting, La Jolla, Calif, Sep 16-19, 2006.

  • Manel Matas, MD

      Affiliations

    • Section of Vascular and Endovascular Surgery, Hospital Universitario Vall d’ Hebron, Universidad Autónoma de Barcelona, Barcelona, Spain
  • ,
  • Beatriz Alvarez, MD

      Affiliations

    • Section of Vascular and Endovascular Surgery, Hospital Universitario Vall d’ Hebron, Universidad Autónoma de Barcelona, Barcelona, Spain
    • Corresponding Author InformationCorrespondence: Beatriz Alvarez, MD, Servicio de Cirugía Vascular y Endovascular. Hospital Universitario, Vall d′Hebron. 6a planta pares. Hospital General, Ciudad Sanitaria Vall d′Hebron, Paseo Vall d′Hebron 119-129, 08035 Barcelona, Spain.
  • ,
  • Marc Ribo, MD

      Affiliations

    • Section of Neurology, Hospital Universitario Vall d’ Hebron, Universidad Autónoma de Barcelona, Barcelona, Spain.
  • ,
  • Carlos Molina, MD

      Affiliations

    • Section of Neurology, Hospital Universitario Vall d’ Hebron, Universidad Autónoma de Barcelona, Barcelona, Spain.
  • ,
  • Jordi Maeso, MD

      Affiliations

    • Section of Vascular and Endovascular Surgery, Hospital Universitario Vall d’ Hebron, Universidad Autónoma de Barcelona, Barcelona, Spain
  • ,
  • Jose Alvarez-Sabin, MD

      Affiliations

    • Section of Neurology, Hospital Universitario Vall d’ Hebron, Universidad Autónoma de Barcelona, Barcelona, Spain.

Received 14 September 2006 ,Accepted 26 February 2007.

References 

  1. Mas JL, Chatellier G, Beyssen B EVA-3S Investigators. Carotid angioplasty and stenting with and without cerebral protection: clinical alert from the Endarterectomy Versus Angioplasty in Patients With Symptomatic Severe Carotid Stenosis (EVA.3S) trial. Stroke. 2004;35:8–20
  2. Ackerstaff R, Suttorp M, van der Berg J, Overtoom T, Vos JA, Bal ET, et al. Antonius Carotid Endarterectomy, Angioplasty and Stenting Study Group (Prediction of early cerebral outcome by transcranial Doppler monitoring in carotid bifurcation angioplasty and stenting). J Vasc Surg. 2005;41:618–624
  3. Mas JL, Chatellier G, Beyssen B, Branchereau A, Moulin T, Becquemin JP, et al. Endarterectomy versus stenting in patients with symptomatic severe carotid stenosis. N Engl J Med. 2006;355:1660–1671
  4. Parodi JC, Ferreira LM, Sicard G, La Mura R, Fernandez S. Cerebral protection during carotid stenting using flow reversal. J Vasc Surg. 2005;41:416–422
  5. Criado E, Doblas M, Fontcuberta J, Orgaz A, Flores A, Wall LP, et al. Transcervical carotid stenting with internal carotid artery flow reversal: feasibility and preliminary results. J Vasc Surg. 2004;40:476–483
  6. Yadav J, Wholey M, Kuntz R, Fayad P, Katzen B, Mishkel G, et al. Stenting and Angioplasty with Protection in Patients at High Risk for Endarterectomy Investigators Protected carotid-artery stenting versus endarterectomy in high-risk patients. N Engl. 2004;351:1493–1501
  7. Alexandrov A. Cerebrovascular ultrasound: stroke prevention and treatment. New York, NY: Blackwell Publishing; 2004;
  8. Ribo M, Molina C, Alvarez B, Rubiera M, Alvarez-Sabin J, Matas M. Transcranial Doppler monitoring of transcervical carotid stenting with flow reversal protection: a novel carotid revascularization technique. Stroke. 2006;37:2846–2849
  9. Criado E, Doblas M, Fontcuberta J, Orgaz A, Flores A. Transcervical carotid artery angioplasty and stenting with carotid flow reversal: Surgical technique. Ann Vasc Surg. 2004;18:257–261
  10. Cremonesi A, Manetti R, Setacci F, Setacci C, Castriota F. Protected carotid stenting: clinical advantages and complications of embolic protection devices in 442 consecutive patients. Stroke. 2003;34:1936–1941
  11. CARESS Steering Committee. Carotid Revascularization Using Endarterectomy or Stenting Systems (CARESS): phase I clinical trial: 1-year results. J Vasc Surg. 2005;42:213–219
  12. Ringleb PA, Allenberg J, Bruckmann H, Eckstein HH, Fraedrich G, Hartmann M, et al. SPACE Collaborative Group 30 day results from the SPACE trial of stent-protected angioplasty versus carotid endarterectomy in symptomatic patients: a randomised non-inferiority trial. Lancet. 2006;368:1239–1247
  13. Al-Mubarak N, Roubin GS, Vitek JJ, Iyer SS, New G, Leon MB. Effect of the distal balloon protection system on microembolization during carotid stenting. Circulation. 2001;104:1999–2002
  14. Schüter M, Tübler T, Steffens JC, Mathey DG, Schofer J. Focal ischemia of the brain after neuroprotected carotid artery stenting. J Am Coll Cardiol. 2003;42:1007–1013
  15. Ohki T, Parodi J, Veith F, Bates M, Bade M, Chang D. Efficacy of a proximal Occlusion catheter with reversal of flow in the prevention of embolic events during carotid artery stenting: an experimental analysis. J Vasc Surg. 2001;33:504–509
  16. Parodi JC, La Mura R, Ferreira LM, Mendez MV, Cersosimo H, Schonholz C. Initial evaluation of carotid angioplasty and stenting with three different cerebral protection devices. J Vasc Surg. 2000;32:1127–1136
  17. Chang DW. Carotid angioplasty and stenting via a mini incision in the neck: technique and updated results. Vascular. 2004;12(supplement):184
  18. Chang DW, Schubart PJ, Veith FJ, Zarins CK. A new approach to carotid angioplasty and stenting with transcervical occlusion and protective shunting: why it may be a better carotid artery intervention. J Vasc Surg. 2004;39:994–1002
  19. Pipinos I, Johanning JM, Pham CN, Soundararajan K, Lynch TG. Transcervical approach with protective flow reversal for carotid angioplasty and stenting. J Endovasc Ther. 2005;12:446–453
  20. Alexandrescu V, Ngongang C, Proumen J, Dejardin J, Serbanescu R, Horion J, et al. Filter-protected carotid stenting via a minimal cervical access with transitory aspirated reversed flow during initial passage of the target lesion. J Endovasc Ther. 2006;13:196–204
  21. Powell RJ, Schermerhorn M, Nolasn B, Lenz J, Rzuidlo Fillinger M, Walsh D, et al Early results of carotid stent placement treatment of extracranial carotid bifurcation occlusive disease. J Vasc Surg. 2004;39:1193–1199
  22. AbuRahma AF, Hayes JD, Deel JT, Abu-Halimah S, Mullins BB, Aviv JH, et al. Complications of diagnostic carotid/cerebral arteriography when performed by a vascular surgeon. Vasc Endovas Surg. 2006;40:189–195
  23. Ohki TM, Veith FJ, Grenell S, Lipstiz EC, Gargiulo N, McKay J. Initial experience with cerebral protection devices to prevent embolization during carotid artery stenting. J Vasc Surg. 2002;36:1175–1185

 Competition of interest: none.

PII: S0741-5214(07)00423-5

doi: 10.1016/j.jvs.2007.02.070

Journal of Vascular Surgery
Volume 46, Issue 1 , Pages 49-54 , July 2007