caa a22 4500 606214917 CHVBK 20210128101056.0 cr unu---uuuuu 210128e20150301xx s 000 0 eng 10.1007/s00701-014-2311-6 doi (NATIONALLICENCE)springer-10.1007/s00701-014-2311-6 Usefulness of dual protection combined with blood aspiration for distal embolic protection during carotid artery stenting [Elektronische Daten] [Shigeyuki Sakamoto, Yoshihiro Kiura, Takahito Okazaki, Katsuhiro Shinagawa, Nobuhiko Ichinose, Masaaki Shibukawa, Yoji Orita, Koji Shimonaga, Yosuke Kajihara, Kaoru Kurisu] Background: We describe dual protection (simultaneous flow reversal and distal filter) combined with blood aspiration as a novel technique to provide distal embolic protection during carotid artery stenting (CAS). Methods: Between July 2011 and August 2014, 190 patients with internal carotid artery (ICA) stenosis underwent 190 CAS procedures as follows. After post-dilation of the stent using dual protection, the aspiration catheter was placed between the distal filter and the proximal end of the stent, and the blood was aspirated several times from the ICA. We assessed hyper-intensity spots in diffusion-weighted images (DWI), and major adverse events (MAE) defined as major stroke, myocardial infarction and death after CAS. We then assessed visible debris captured in aspirated blood, the distal filter and a blood filter during flow reversal. Results: The overall technical success rate was 100%, and all stenoses were dilated. Hyper-intense spots were found in 33 (17.3%) of 190 DWI. The rate of MAE within 30days was 1.05% (2/190). Visible debris in 175 of 190 CAS procedures was captured in 92 (52.5%) of these 175. In 25 (27.2%) of these 92, visible debris was captured in all of aspirated blood, the distal filter and the blood filter during flow reversal, only the blood filter during flow reversal (n = 19; 20.7%), only the distal filter (n = 14; 15.2%), only aspirated blood (n = 11; 12%), aspirated blood and the blood filter during flow reversal (n = 10; 10.8%), aspirated blood and the distal filter (n = 7; 7.6%) and the distal filter and blood filter during flow reversal (n = 6; 6.5%). Conclusions: Adding a distal filter and blood aspiration to flow reversal during CAS could provide effective distal embolic protection. Springer-Verlag Wien, 2014 Blood aspiration nationallicence Carotid artery stenting nationallicence Distal filter nationallicence Flow reversal nationallicence Visible debris nationallicence Sakamoto Shigeyuki Department of Neurosurgery, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3 Kasumi, 734-8551, Minami-ku, Hiroshima, Japan aut Kiura Yoshihiro Department of Neurosurgery, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3 Kasumi, 734-8551, Minami-ku, Hiroshima, Japan aut Okazaki Takahito Department of Neurosurgery, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3 Kasumi, 734-8551, Minami-ku, Hiroshima, Japan aut Shinagawa Katsuhiro Department of Neurosurgery, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3 Kasumi, 734-8551, Minami-ku, Hiroshima, Japan aut Ichinose Nobuhiko Department of Neurosurgery, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3 Kasumi, 734-8551, Minami-ku, Hiroshima, Japan aut Shibukawa Masaaki Department of Neurosurgery, JA Hiroshima General Hospital, 1-3-3 Jigozen, 738-8503, Hatsukaichi, Hiroshima, Japan aut Orita Yoji Department of Neurosurgery, JA Hiroshima General Hospital, 1-3-3 Jigozen, 738-8503, Hatsukaichi, Hiroshima, Japan aut Shimonaga Koji Department of Neurosurgery, JA Hiroshima General Hospital, 1-3-3 Jigozen, 738-8503, Hatsukaichi, Hiroshima, Japan aut Kajihara Yosuke Department of Neurosurgery, Itsukaichi Memorial Hospital, 1-95 Kurashige, 731-5156, Saeki-ku, Hiroshima, Japan aut Kurisu Kaoru Department of Neurosurgery, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3 Kasumi, 734-8551, Minami-ku, Hiroshima, Japan aut Acta Neurochirurgica Springer Vienna 157/3(2015-03-01), 371-377 0001-6268 157:3<371 2015 157 701 https://doi.org/10.1007/s00701-014-2311-6 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00701-014-2311-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Sakamoto Shigeyuki Department of Neurosurgery, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3 Kasumi, 734-8551, Minami-ku, Hiroshima, Japan aut NATIONALLICENCE 700 1- Kiura Yoshihiro Department of Neurosurgery, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3 Kasumi, 734-8551, Minami-ku, Hiroshima, Japan aut NATIONALLICENCE 700 1- Okazaki Takahito Department of Neurosurgery, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3 Kasumi, 734-8551, Minami-ku, Hiroshima, Japan aut NATIONALLICENCE 700 1- Shinagawa Katsuhiro Department of Neurosurgery, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3 Kasumi, 734-8551, Minami-ku, Hiroshima, Japan aut NATIONALLICENCE 700 1- Ichinose Nobuhiko Department of Neurosurgery, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3 Kasumi, 734-8551, Minami-ku, Hiroshima, Japan aut NATIONALLICENCE 700 1- Shibukawa Masaaki Department of Neurosurgery, JA Hiroshima General Hospital, 1-3-3 Jigozen, 738-8503, Hatsukaichi, Hiroshima, Japan aut NATIONALLICENCE 700 1- Orita Yoji Department of Neurosurgery, JA Hiroshima General Hospital, 1-3-3 Jigozen, 738-8503, Hatsukaichi, Hiroshima, Japan aut NATIONALLICENCE 700 1- Shimonaga Koji Department of Neurosurgery, JA Hiroshima General Hospital, 1-3-3 Jigozen, 738-8503, Hatsukaichi, Hiroshima, Japan aut NATIONALLICENCE 700 1- Kajihara Yosuke Department of Neurosurgery, Itsukaichi Memorial Hospital, 1-95 Kurashige, 731-5156, Saeki-ku, Hiroshima, Japan aut NATIONALLICENCE 700 1- Kurisu Kaoru Department of Neurosurgery, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3 Kasumi, 734-8551, Minami-ku, Hiroshima, Japan aut NATIONALLICENCE 773 0- Acta Neurochirurgica Springer Vienna 157/3(2015-03-01), 371-377 0001-6268 157:3<371 2015 157 701