Carotid artery stenting with or without distal filter-type embolic protection device: A single center experience

Abstract

Aim: To share the data of patients who underwent carotid artery stenting (CAS) with or without a distal filter-type (DF) embolic protection device (EPD) in our clinic and our own experiences.

Method: The files of patients who underwent CAS in our clinic between November 2019 and January 2021 were reviewed retrospectively. Patients with >50% stenosis in symptomatic patients, >70% in asymptomatic patients, and those who had CAS at least 48 hours after the last symptom were included. Patients who underwent acute CAS and were treated for restenosis after carotid stent or endarterectomy were excluded from the study. Thirty-five patients who used DF in CAS procedure and 16 patients who did not use EPD were included in the study. 

Results: No significant difference was found between the two groups in terms of new neurological and cardiac vascular events (p=0.58). A new ischemic lesion was detected in diffusion MRI in 76.5% of the patients who underwent CAS using a DF type EPD and 81.8% of patients who underwent CAS without the use of an EPD. No significant difference was found between the detection rates of new ischemic lesions (p=0.73).

Conclusions: Since we found no significant difference in neurological and cardiac vascular events between the patients who underwent CAS with and without use of DF type EPD, we suggest that CAS can be performed without the use of a DF type EPD in suitable patients to reduce the cost of the procedure.