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Yusuf Demir1, Oktay Şenöz1, Abdurrahman Eren2, Alirıza Demir2
1Department of Cardiology, Bakırçay University, Izmir, Türkiye
2Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Türkiye
Keywords: Carotid artery stenting, embolism protection, microemboli
Objectives: This study aimed to evaluate the effect of using or not using a protective device on clinical outcomes in patients undergoing carotid artery stenting.
Patients and methods: A total of 80 patients (53 males, 27 females; mean age: 68.1±9.1 years; range, 47 to 93 years) with symptomatic severe carotid artery stenosis or asymptomatic severe carotid artery stenosis were included in the prospective study between March 2016 and August 2018. The patients were divided into two groups: those who used an embolism protection device (n=60) and those who did not (n=20).
Results: In terms of primary endpoints, rates of ischemic stroke (5% vs. 5%, p=1.00) and transient ischemic attack (5% vs. 0%, p=0.56) were found to be similar between the protected and unprotected groups after carotid artery stenting. While total embolism numbers (2.11±2.62 vs. 1.26±2.19, p=0.072) and infarct sizes (8.80±4.5 mm vs. 9.00±5.05 mm, p=0.97) were similar between the protected and unprotected groups, the presence of silent microemboli was higher in the unprotected group (40% vs. 15%, p=0.02).
Conclusion: Although embolism protection devices do not reduce the risk of clinically significant embolism, they significantly reduce the
risk of silent microemboli.
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