Carotid Artery Stenting Using the Double Embolic Protection Technique

Abstract

Objectives: Severe internal carotid artery stenosis is observed in 2%-8% of the population and responsible for 20%-30% of all strokes. The reliability of carotid artery stenting in high-risk patients with high thrombus burden and vulnerable plaques and the treatment strategy in these patients remain unclear. Our aim in this study was to evaluate the short-term and long-term results of the use of double embolism protection devices in high-risk patients. Materials and Methods: Patients who underwent carotid artery stenting between December 2016 and 2019 in our center were evaluated retrospectively. Among these patients, 17 patients in whom double embolism protection devices were used during stenting procedure were included in the study. Results: The mean age of the patients was 76±7.1 years and 13 of them were male. All patients had hypertension and 82.3% had diabetes mellitus. All patients were symptomatic. Both distal and proximal cerebral protection devices were used together during the procedure. While no death was observed after the procedure, contralateral major stroke was observed in one patient and transient ischemic attack was observed in two patients. Restenosis was not observed in the control carotid Doppler ultrasonography, which was performed after the procedure, within the first year of follow up. Conclusion: In this study, the feasibility and reliability of using distal and proximal cerebral protection devices together in high-risk patients were shown. Carotid stenting and double cerebral protection devices can be applied with acceptable complications in experienced centers and in suitable patients, especially in those with high surgical risk