Bastug Gul Zeynep, Akkaya Emre, Vuruskan Ertan, Akgul Ozgur, Pusuroglu Hamdi, Surgit Ozgur, Ozbay Ozyilmaz Sinem, Rodi Tosu Aydin, Altug Cakmak Huseyin, Gode Safa, Gul Mehmet
1 Department of Neurology, Dr. Mazhar Osman Teaching and Research Hospital for Mental Health and Neurological Disorders, Istanbul, Turkey.
Vasa. 2015 Jul;44(4):297-304. doi: 10.1024/0301-1526/a000445.
The aim of this study was to assess the periprocedural and one-year outcomes of two different cerebral protection systems used during carotid artery stenting (CAS).
We enrolled 90 consecutive patients with carotid artery stenosis who underwent CAS with a proximal flow blockage protection system (mean age 69.7 ± 8) or distal protection with a filter (mean age 70.8 ± 7).
CAS was performed successively on 89 patients (99 %). Adverse events were defined as major stroke, minor stroke, transient ischemic attack (TIA), myocardial infarction, and death. Two strokes, one TIA, one death, and one myocardial infarction were observed in-hospital. There were no significant differences in safety or benefits between the proximal flow blockage embolic protection system (n = 45) and the distal filter protection system (n = 45) in terms of clinically apparent cerebral embolism, TIA, death, or myocardial infarction during the periprocedural stage or during the one-year follow-up period.
Although it has been shown that the proximal flow blockage cerebral protection system decreases the risk of silent cerebral embolism, it has no advantage over the distal filter protection system in terms of adverse cerebrovascular or cardiac events during the periprocedural stage or during the long-term follow-up period.
本研究旨在评估在颈动脉支架置入术（CAS）期间使用的两种不同脑保护系统的围手术期及一年期结局。
我们连续纳入90例患有颈动脉狭窄的患者，这些患者接受了采用近端血流阻断保护系统的CAS（平均年龄69.7±8岁）或采用滤网的远端保护（平均年龄70.8±7岁）。
89例患者（99%）成功进行了CAS。不良事件定义为重大卒中、轻度卒中、短暂性脑缺血发作（TIA）、心肌梗死和死亡。住院期间观察到2例卒中、1例TIA、1例死亡和1例心肌梗死。在围手术期或一年随访期内，就临床明显的脑栓塞、TIA、死亡或心肌梗死而言，近端血流阻断栓塞保护系统（n = 45）和远端滤网保护系统（n = 45）在安全性或获益方面无显著差异。
尽管已表明近端血流阻断脑保护系统可降低无症状脑栓塞的风险，但在围手术期或长期随访期内，就不良脑血管或心脏事件而言，其并不优于远端滤网保护系统。
