Stent-Protected Carotid Angioplasty Using a Membrane Stent: A Comparative Cadaver Study
- University Hospital, Schleswig-Holstein-Campuskiel, Department of Radiology (Germany)
- UKE Hamburg Eppendorf, Department of Forensic Medicine (Germany)
- Vascular Enterprises Ltd. (Dublin, Ireland), Abbott Laboratories (Switzerland)
- University Hospital, Martin Luther University, Institute for Anatomy and Cell Biology (Germany)
- Institute for Medical Statistics, UKSH-Campus Kiel (Germany)
Purpose. To evaluate the performance of a prototype membrane stent, MembraX, in the prevention of acute and late embolization and to quantify particle embolization during carotid stent placement in human carotid explants in a proof of concept study. Methods. Thirty human carotid cadaveric explants (mild stenoses 0-29%, n = 23; moderate stenoses 30-69%, n = 3; severe stenoses 70-99%, n = 2) that included the common, internal and external carotid arteries were integrated into a pulsatile-flow model. Three groups were formed according to the age of the donors (mean 58.8 years; sample SD 15.99 years) and randomized to three test groups: (I) MembraX, n 9; (II) Xpert bare stent, n = 10; (III) Xpert bare stent with Emboshield protection device, n = 9. Emboli liberated during stent deployment (step A), post-dilatation (step B), and late embolization (step C) were measured in 100 {mu}m effluent filters. When the Emboshield was used, embolus penetration was measured during placement (step D) and retrieval (step E). Late embolization was simulated by compressing the area of the stented vessel five times. Results. Absolute numbers of particles (median; >100 {mu}m) caught in the effluent filter were: (I) MembraX: A = 7, B = 9, C = 3; (II) bare stent: A 6.5, B = 6, C = 4.5; (III) bare stent and Emboshield: A = 7, B = 7, C.=.5, D = 8, E = 10. The data showed no statistical differences according to whether embolic load was analyzed by weight or mean particle size. When summing all procedural steps, the Emboshield caused the greatest load by weight (p 0.011) and the largest number (p = 0.054) of particles. Conclusions. On the basis of these limited data neither a membrane stent nor a protection device showed significant advantages during ex vivo carotid angioplasty. However, the membrane stent seems to have the potential for reducing the emboli responsible for supposed late embolization, whereas more emboli were observed when using a protection device. Further studies are necessary and warranted.
- OSTI ID:
- 21091176
- Journal Information:
- Cardiovascular and Interventional Radiology, Journal Name: Cardiovascular and Interventional Radiology Journal Issue: 4 Vol. 29; ISSN 0174-1551; ISSN CAIRDG
- Country of Publication:
- United States
- Language:
- English
Similar Records
Evaluation of Angiographic and Technical Aspects of Carotid Stenting with Diffusion-Weighted Magnetic Resonance Imaging
Complications and Follow-up after Unprotected Carotid Artery Stenting