Early results of endovascular treatment of patients with bilateral stenoses of the internal carotid arteries using proximal protection systems at 30-day follow-up
Background: Although surgical endarterectomy remains the treatment of choice for carotid
artery stenosis, carotid artery stenting (CAS) with use of proximal protection systems (PPS)
plays an very important role as alternative treatment modality, especially in patients with
critical, symptomatic lesions.
This study was single-centre study to evaluate the technical and clinical success of
proximal protection devices as the first choice for embolic protection in symptomatic and
asymptomatic carotid stenosis in patients with bilateral, advanced lesions of carotid arteries
(bilateral stenoses or stenosis and occlusion).
Methods: This was a post hoc analysis, with 30-day follow up. We analyzed results of
treatment of 38 patients who underwent 38 CAS with PPS, 17 such procedures in asymptomatic (group A), and 21 in symptomatic individuals (group B). The GORE® Flow Reversal
System (W.L. Gore, Flagstaff, AZ, USA) was used in 2 patients, and the Mo.Ma Ultra device
(Medtronic, Minneapolis, MN, USA) in 36 patients. Mean age was 68 7 years, 65% percent of
patient were male.
Results: There were no procedural and during 30-day follow-up neurologic events. Intolerance of occlusion system occurred in 4 patients (11%) in both groups with any later
symptoms. Risk factors of this adverse event comprised: lesions of the left internal carotid
lesion and coexisiting diabetes mellitus.
Conclusions: CAS in high risk patients with bilateral lesions of carotid arteries with the use of
PPS seems to be a relatively very safe procedure
