Reversal of flow during carotid artery stenting: use of the Parodi antiembolism system.

Journal article

INTRODUCTION: To evaluate the flow reversal efficacy of the Parodi antiembolism system (PAES) in the prevention of distal emboli during carotid stenting. METHODS: A total of 90 patients were treated for internal carotid artery (ICA) stenosis with a stent device. A PAES device was used in 31 symptomatic and 5 asymptomatic patients (total 36 patients) with ICA stenosis, and 54 patients were stented without any protection device. Diffusion-weighted (DW) imaging was performed before and after stenting. RESULTS: In the group without PAES protection, 23 out of 54 patients showed new lesions on DW images after stenting. Of the lesions seen, 147 (2.72 lesions/patient) were in the vessel-dependent area. In the group with protection, 19 out of 36 patients had new lesions, and only 34 (0.94 lesions/patient) were noted in the vessel-dependent area. The number of new lesions in the nondependent vessel area did not differ if a protection system was used (P = 0.671). The use of PAES led to a significant reduction (P = 0.024) in the incidence of the most frequently seen lesions (size <2 mm). The stroke death rate was 3.3% overall, 3.7% in the group without protection device, and 2.7% in the PAES group. There were no permanent neurological deficits after 3 months. CONCLUSION: The PAES is a safe and effective tool to reduce the incidence of embolic complications during carotid stenting. Older patients and patients with higher grade stenosis seem to profit more.

Authors: Grunwald, I; Papanagiotou, P; Struffert, T; Politi, M; Krick, C

• Journal: Neuroradiology
• Volume: 49
• Issue: 3
• Pages: 237-241
• Publication date: 2007-03-01
• DOI: 10.1007/s00234-006-0178-9
• EISSN: 1432-1920
• ISSN: 0028-3940
• Language: English
• Keywords: Regional Blood Flow; Catheterization; Intracranial Embolism; Aged; Angiography; Carotid Stenosis; Humans; Female; Male; Blood Flow Velocity; Diffusion Magnetic Resonance Imaging; Statistics, Nonparametric; Stents