(BQ) Part 2 book “Carotid artery stenting - Current practice and techniques” has contents: Intravascular filter anti-embolization systems, restenosis following carotid artery stenting, limitations of current equipment and the future carotid artery stenting device, clinical investigations and protocols, and other contents. | 15 CAROTID ARTERY STENTING WITH THE DISTAL OCCLUSION ANTIEMBOLIZATION SYSTEM MICHEL HENRY ANTONIOS POLYDOROU ISABELLE HENRY M I C H E` L E H U G E L Despite meticulous techniques and the advanced experience, embolic stroke represents a major drawback of the carotid stenting procedure (CAS). The majority of the neurological complications are due to the intracerebral embolism of plaque fragments or thrombus during different procedural steps. Anti-Embolization devices have been developed to reduce the incidence of embolic events during CAS (29–32). We have prospectively examined the outcome of CAS under cerebral protection using the distal occlusion balloon protection (GuardWire System, PercuSurge–Medtronic, Minneapolis, MN) to assess whether this therapy is comparable to historical controls of both carotid endarterectomy and CAS without Anti-Embolization. Between February 1998 and February 2002, 238 patients (264 carotid stenoses) met the inclusion criteria and underwent CAS under protection using the GuardWire AntiEmbolization system. Patients were eligible for treatment if they had more than or equal to 70% diameter stenosis of the internal carotid artery (ICA) evaluated by angiography according to the North American Symptomatic Carotid Endarterectomy Trial (NASCET) criteria (2). We excluded the following patients from the treatment: multiple stenoses in the ICA, intracranial pathology, presence of angiographically visible thrombus, gastrointestinal bleeding in the last 6 months, and hemorrhagic disorders. All patients should receive aspirin 75 to 300 mg per day indefinitely and ticlopidine 250 to 500 mg per day or clopidogrel 75 mg per day for at least 2 days and preferably 1 week before the procedure and for 1 month after it. Unfractionated heparin (5000 IU intravenously) and atropine (1 mg intravenously) are routinely administered just after the introducer sheath is placed. Patients were usually discharged the day after the procedure. All patients underwent .
