Embolic risk of the different stages of carotid bifurcation balloon angioplasty: An experimental study

Abstract

Carotid balloon angioplasty generates embolic particles after each stage of the procedure. Techniques of prevention should then be effective from the initial step of the angioplasty procedure, and the selection of patients for carotid angioplasty remains crucial.

Carotid Stenting without Use of Balloon Angioplasty and Distal Protection Devices: Preliminary Experience in 100 Cases

“…MES are detected by TCD during all of the procedural phases of CAS: sheath placement, guidewire ma- nipulation, CPD introduction and placement, balloon predilation and postdilation, and CPD removal. 20,28 In our study, more MESs were recorded by TCD during advancement of a wire across the stenosis than during the stent delivery system advancement and deployment across the stenotic segment. Although TCD has proved that the procedure-related embolization during CAS is higher than that during CAE, the clinical significance of microemboli, however, is not clear.…”

“…Although TCD has proved that the procedure-related embolization during CAS is higher than that during CAE, the clinical significance of microemboli, however, is not clear. 28 The incidence of perioperative major stroke in our series was 1%, with 1 minor stroke. No fatal major strokes or deaths were related to the procedure.…”

Effectiveness of Mechanical Endovascular Thrombectomy in a Model System of Cerebrovascular Occlusion

“…The Coulter principle was applied in 2 prior ex vivo studies to count and size the embolic fragments from the human atherosclerotic plaques that were released with ex vivo carotid angioplasty, 23,24 and the authors concluded that hundreds of thousands of microemboli were generated during angioplasty. In this study, we calculated and compared the mean number of clot fragments in the effluent following MET with different devices.…”

Carotid Artery Stenting without Angioplasty and Cerebral Protection: A Single-Center Experience with up to 7 Years' Follow-Up

“…9,10 Moreover, embolic signals have been observed by TCD during all phases of the carotid stent procedure, whereas in a recent study, more signals were detected with the use of filter devices. 11 Therefore, it is rational to expect that less manipulation and fewer devices crossing the stenosis may reduce the risk of stroke during CAS. Indeed, a preliminary experience in CAS-WBAP demonstrated a low 30-day stroke/death rate.…”