PurposePreventing cerebral embolism from debris produced during carotid artery stenting (CAS) is important. This study compared the treatment outcomes of CAS using two types of filter-based embolic protection devices currently in use in Japan.Materials and methodsWe assessed 121 consecutive cases of CAS performed with FilterWire EZ™ between July 2010 and November 2012 and 37 consecutive cases of CAS performed with the Spider FX™ between November 2012 and June 2013. A Carotid Wallstent™ was used in all cases. The incidence of positive lesions on diffusion-weighted magnetic resonance imaging (DWI) and stroke were compared between the groups.ResultsPostoperative DWI-positive lesions were observed in 38 (31.4%) and 14 (37.8%) patients in the FilterWire and Spider groups, respectively. In the FilterWire group, complications were transient ischemic attacks in 3 (2.5%) patients, cerebral infarction in 2 (1.7%) patients (1 patient each with minor and major stroke), and cerebral hemorrhage due to hyperperfusion syndrome in 1 (0.8%) patient. In the Spider group, except for cerebral infarction (minor stroke) in 1 (2.7%) patient, no complications were observed. No significant differences were observed in the incidence of complications between the groups.ConclusionFilterWire EZ and Spider FX are comparable in terms of treatment outcome.
profile visualized intraluminal support (LVIS) Jr. was useful, and review its usefulness and tips. Case Presentations: Case 1: A 75-year-old male with a left internal carotid-posterior communicating (IC-PC) aneurysm (maximum diameter: 11 mm, neck diameter: 7.0 mm). The posterior communicating (P-com; 2.3 mm) had branched from the aneurysmal dome. Stent-assisted coil embolization (SACE) was performed by inserting an LVIS Jr. 3.5 × 28 on the fetal-type posterior cerebral artery (PCA). P-com side and an LVIS Jr. 3.5 × 18 on the internal carotid artery (ICA) side (T-stent technique). Case 2: An 80-year-old female with a right IC-PC aneurysm (maximum diameter: 6.0 mm, neck diameter: 5.4 mm). The P-com (2.2 mm) had branched from the aneurysmal dome. SACE was performed by inserting an LVIS Jr. 2.5 × 13 on the fetal-type PCA. P-com side and a Neuroform Atlas 4.5 × 21 on the ICA side. Case 3: A 61-year-old female with a left vertebral artery (VA)-posterior inferior cerebellar artery (PICA) aneurysm (maximum diameter: 6.4 mm, neck diameter: 5.6 mm, PICA diameter: 2.2 mm). SACE was performed by inserting an LVIS Jr. 2.5 × 13 on the PICA side and an LVIS Blue 4.5 × 23 on the VA side. Conclusion: The T-stent technique with an LVIS Jr. was useful for achieving neck formation for a wide-necked aneurysm directly branching from an aneurysm or preserving branches measuring ≥2 mm in diameter. We reported its tips.
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