Study Evaluates Proximal Protection Devices During CAS as First Choice for Embolic Protection

March 23, 2015—Proximal protection is a safe method as the first choice for embolic protection and can be used with a high rate of technical success, according to findings from a single-center study published by Marius Hornung, MD, et al in EuroIntervention (2015;10:1362–1367). The study’s objective was to assess the use of proximal protection devices in consecutive patients as the preferred means of cerebral embolic protection for primary carotid stenting.

In this prospective, single-center study, the investigators evaluated the technical and clinical success of proximal protection devices as the first choice for embolic protection in patients with symptomatic (≥ 50%) and asymptomatic (≥ 70%) carotid stenoses. Proximal protection devices were used for embolic protection in 124 consecutive patients. No patients were excluded for anatomical reasons. The Gore Flow Reversal System (Gore & Associates) was used in 92 patients, and the Mo.Ma Ultra device (Medtronic) was used in 32 patients. 

As summarized in EuroIntervention, the study’s follow-up duration was 30 days. The mean patient age was 71 ± 8 years, and 75% of patients were men (n = 93). Twenty-six of 124 treated stenoses (21%) were symptomatic. Technical success was achieved in 122 of 124 cases (98%). 

Due to anatomical conditions, flow reversal could not be established in two patients. In both cases, additional distal filter devices were used. Carotid stenting was successful in 124 lesions (100%), and there were no procedural neurologic events. Ten patients (8.1%) had contraindications to flow reversal but none experienced complications. Within 30 days of follow-up, one patient had an ischemic stroke on day 11, reported the investigators in EuroIntervention.