Proximal Embolic Protection Devices in Complicated Carotid Artery Stenting

Ann Vasc Surg. 2017 Oct:44:416.e1-416.e4. doi: 10.1016/j.avsg.2017.04.037. Epub 2017 May 5.

Abstract

The most frequent complication during carotid artery stenting (CAS) is intraoperative distal embolization. Three categories of embolic protection devices (EPDs) are routinely used through a transfemoral or transcervical approach: distal occlusion devices, distal EPDs with flow preservation using filters, and the proximal occlusive protective systems. We report the case of the internal carotid artery (ICA) plaque rupture during CAS using a proximal EPD (the Mo.Ma system; INVATEC), treated with immediate surgery. The proximal occlusive protective system permitted the common carotid artery and ICA endoclamping for the time necessary to prepare the patient for the carotid endarterectomy. The EPDs should always be chosen considering the patient's and lesion's characteristics. This knowledge allows their use even as "bridge" endovascular devices.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Angiography
  • Carotid Artery, Internal / diagnostic imaging
  • Carotid Artery, Internal / physiopathology
  • Carotid Artery, Internal / surgery*
  • Carotid Stenosis / diagnostic imaging
  • Carotid Stenosis / physiopathology
  • Carotid Stenosis / therapy*
  • Conversion to Open Surgery*
  • Embolic Protection Devices*
  • Endarterectomy, Carotid*
  • Endovascular Procedures / adverse effects
  • Endovascular Procedures / instrumentation*
  • Humans
  • Male
  • Plaque, Atherosclerotic
  • Prosthesis Design
  • Rupture, Spontaneous
  • Stents*
  • Treatment Outcome