Routine aspiration method during filter-protected carotid stenting: histological evaluation of captured debris and predictors for debris amount
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Takatoshi Sorimachi & Akiyoshi Kakita & Kenichi Morita & Kazuhiko Nishino & Osamu Sasaki & Tetsuo Koike & Takashi Kumagai & Yasushi Ito & Yukihiko Fuj
- چاپ و سال / کشور: 2011
Description
Background A routine aspiration method in filter-protected carotid artery stenting (CAS) has been reported recently in which the proximal internal carotid artery (ICA) blood column was aspirated using an aspiration catheter after postdilatation regardless of flow state on digital subtraction angiography. We examined the debris particles captured by this method. Methods The routine aspiration method was used in 71 CAS procedures. In two procedures, captured debris particles were examined histologically. In the remaining 69 procedures, the size and number of debris particles were measured under a stereoscopic microscope, and then relationships between the amount of debris particles and clinical variables were evaluated using multivariate regression analysis. Results Histologically, the captured debris contained platelet-precipitating, thrombotic, lipid-rich fibrous and calcified material. The number of debris particles .1 mm was 19.6پ}12.1 (mean پ} SD) in 60 procedures with normal flow and 25.9پ}17.2 (mean پ} SD) in 9 procedures with slow/stop flow. Multivariate regression analysis demonstrated that extension of a proximal ICA angulation was an independent predictor of the amount of debris particles with a maximum diameter of either .1mmor <1mmbut .0.5 mm (p<0.05). Conclusions The captured debris appeared to originate from atheromatous plaques. If the routine aspiration method had not been used in the present series, the debris might have migrated into intracerebral arteries. Restriction of the extension of a proximal ICA angulation might reduce the amount of debris associated with CAS, especially when the proximal ICA angulation is pronounced
Acta Neurochir DOI 10.1007/s00701-011-1093-3 Received: 5 April 2011 / Accepted: 14 July 2011
