Vascular Medicine

 

Advanced Search

Journal Navigation

Journal Home

Subscriptions

Archive

Contact Us

Table of Contents

Sign In to gain access to subscriptions and/or personal tools.
This Article
Right arrow Full Text (PDF)
Right arrow References
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Saved Citations
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Request Reprints
Right arrow Add to My Marked Citations
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Macdonald, S.
Right arrow Articles by Gaines, P. A
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Macdonald, S.
Right arrow Articles by Gaines, P. A
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?
Vascular Medicine, Vol. 8, No. 1, 25-32 (2003)
DOI: 10.1191/1358863x03vm464ra

Current concepts of mechanical cerebral protection during precutaneous carotid intervention

Sumaira Macdonald

Sheffield Vascular Institute, Sheffield, UK, sumaira{at}primedia.co.uk

Peter A Gaines

Sheffield Vascular Institute, Sheffield, UK

Major advances in the endovascular treatment of carotid artery stenosis are underway, with an emphasis on improving the safety profi le of the technique. This review highlights key areas in the concepts and design of available mechanical neuroprotection devices utilized during carotid stenting to minimize procedural cerebral embolization. The advantages and disadvantages of each system are explored and the available clinical experience is given. The size threshold of particulate material likely to be clinically relevant is examined and compared with pathological analysis of particles trapped by protection systems reported in the world literature. It is shown that the adverse neurological event rate in those protected is lower than that in historical studies of unprotected carotid stenting. Furthermore, the size range and numbers of particles trapped by protections systems are suffi cient to cause potential neurological injury if allowed passage to the brain. Further improvements in outcomes may require further refi nement of protection technology.

Key Words: carotid stenosis • cerebral protection • stenting


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?