Proximal versus distal embolic protection for carotid artery stenting: a national cardiovascular data registry analysis.
Publication/Presentation Date
4-20-2015
Abstract
OBJECTIVES: The aim of this study was to compare the stroke/death rates between proximal embolic protection devices (P-EPDs) and distal filter embolic protection devices (F-EPDs) in elective carotid artery stenting (CAS).
BACKGROUND: P-EPDs have theoretical advantages that may make them superior to F-EPDs for stroke prevention during CAS.
METHODS: We examined 10,246 consecutive elective CAS procedures performed with embolic protection in the NCDR CARE registry between January 2009 and March 2013. We analyzed crude and propensity-matched rates of in-hospital combined death/stroke in patients treated with P-EPDs versus F-EPDs. Secondary analyses included 30-day adverse event rates and stroke rates by the involved cerebrovascular territory.
RESULTS: P-EPDs were used in 590 of 10,246 cases (5.8%). Patients treated with P-EPDs had higher rates of symptomatic lesion status (46.8% vs. 39.7%, p
CONCLUSIONS: Use of a P-EPD during CAS was associated with low rates of in-hospital stroke/death similar to those with an F-EPD in the first comparative effectiveness study of the devices. An adequately powered randomized trial comparing clinical outcomes between these devices is unlikely to be feasible.
Volume
8
Issue
4
First Page
609
Last Page
615
ISSN
1876-7605
Published In/Presented At
Giri, J., Parikh, S. A., Kennedy, K. F., Weinberg, I., Donaldson, C., Hawkins, B. M., McCormick, D. J., Jackson, B., Armstrong, E. J., Ramchand, P., White, C. J., Jaff, M. R., Rosenfield, K., & Yeh, R. W. (2015). Proximal versus distal embolic protection for carotid artery stenting: a national cardiovascular data registry analysis. JACC. Cardiovascular interventions, 8(4), 609–615. https://doi.org/10.1016/j.jcin.2015.02.001
Disciplines
Medicine and Health Sciences
PubMedID
25907088
Department(s)
Department of Surgery
Document Type
Article