This poster was previously presented in Spanish at the 2012 Congreso Nacional SERAM (Granada)
Type:
Educational Exhibit
Keywords:
Interventional vascular, Neuroradiology brain, Vascular, Fluoroscopy, Angioplasty, Stents, Arteriosclerosis
Authors:
M. Espinosa de Rueda Ruiz, J. Zamarro Parra, B. García-Villalba Navaridas, G. Parrilla Reverter, P. Hernández Fernández, A. Moreno Diéguez; Murcia/ES
DOI:
10.1594/ecr2013/C-0239
Background
CAS is an accepted modality of intervention for treatment of carotid atheromatous disease.
Nevertheless its periprocedural morbimortality is a frequent focus of discussion and there is a permanent comparison to endarterectomy.
Lots of publications have shown the safety and efficacy of CAS even those in patients with a high surgical risk.
Furthermore,
the widespread use of protection devices has increased the safety of this intervention,
thanks to the reduction of intracranial embolisation of debris produced during manipulation of the atheromatous plaque.
There are distal protection devices (generally called “protection filters”),
which must cross the target lesion and be deployed beyond it,
and there are proximal protection devices,
which are deployed before the stenotic plaque so you only cross the lesion with intention to treat in safety conditions.
The MO.MA device (Medtronic Invatec,
Roncadelle,
Italy) has been available in Europe for more than ten years,
and it is especially useful with important arterial tortuosity and dangerous and brindle plaques,
where conventional filters could not cross to be distally deployed.
There are studies analysing the rate of thromboembolic events comparing proximal and distal protection devices,
using Transcranial Doppler (TCD) and diffusion MRI sequences.
They appreciate that the use of proximal systems produces less thromboembolic phenomena.
Furthermore,
the studies of ASC with proximal protection devices do not show more periprocedural complications or major events at 30 days.