Jaeger H, Mathias K, Drescher R, Hauth E, Bockisch G, Demirel E, Gissler H M
Department of Radiology, Staedtische Kliniken Dortmund, Germany.
Cardiovasc Intervent Radiol. 2001 Jul-Aug;24(4):249-56. doi: 10.1007/s00270-001-0013-y.
To assess the technical feasibility and the clinical results of cerebral protection with the Angioguard emboli-capture guidewire system during carotid artery stenting (CAS) for high-grade stenoses.
In 20 patients 20 stenoses of the internal carotid artery were treated with stent implantation. In all patients diffusion-weighted (DW) magnetic resonance imaging (MRI) of the brain was performed before and 24 hr after the procedure.
The filter device was effectively employed during all steps of the procedure in 16 of 20 patients, in two only postdilation could be protected, and in two no protection was possible. After three of the 20 procedures new ipsilateral cerebral lesions were visualized by DW-MRI. No new permanent neurologic deficits occurred.
Cerebral protection with the filter device is technically feasible in most cases. DW-MRI demonstrated new cerebral lesions indicating the occurrence of cerebral microemboli during the protected procedures. Further investigations are necessary to determine whether the use of the cerebral protection device will improve the results of CAS.
评估在颈动脉支架置入术（CAS）治疗高度狭窄时，使用Angioguard栓子捕获导丝系统进行脑保护的技术可行性和临床结果。
对20例患者的20处颈内动脉狭窄进行支架植入治疗。所有患者在手术前和手术后24小时均进行了脑部弥散加权（DW）磁共振成像（MRI）检查。
20例患者中有16例在手术的所有步骤中均有效使用了滤器装置，2例仅在球囊扩张后得到保护，2例无法进行保护。20例手术中有3例术后通过DW-MRI发现新的同侧脑损伤。未出现新的永久性神经功能缺损。
在大多数情况下，使用滤器装置进行脑保护在技术上是可行的。DW-MRI显示了新的脑损伤，表明在受保护的手术过程中发生了脑微栓子。需要进一步研究以确定使用脑保护装置是否会改善CAS的结果。
