+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Blood flow changes caused by distal filter protection and catheter aspiration in the internal carotid artery during carotid stenting: evaluation using carotid Doppler sonography

Blood flow changes caused by distal filter protection and catheter aspiration in the internal carotid artery during carotid stenting: evaluation using carotid Doppler sonography

Ajnr. American Journal of Neuroradiology 32(2): 288-293

If blood flow in the ICA is reduced by the use of a distal filter during CAS, flow stagnation proximal to the filter occurs and this increases the probability of floating debris. The floating debris that remains after filter retrieval may cause cerebral embolism. However, if blood flow is increased by aspiration of blood from the ICA through an aspiration catheter, debris could be removed while the filter is still in place. The purpose of this study was to investigate blood flow changes in the ICA induced by filter use and aspiration. A filter-protection device (AngioGuard XP) was used during CAS in 13 consecutive patients with carotid stenosis. Blood flow velocity in the ICA was measured by carotid Doppler sonography during filter deployment, filter retrieval, and catheter aspiration. Blood flow velocity significantly decreased with filter placement and significantly increased with filter retrieval in patients with normal angiographic flow (P < .05). Aspiration of a 20-mL blood sample from the proximal ICA column significantly increased the blood flow velocity (P < .05). The blood flow changes in the ICA induced by the use of a distal filter may cause cerebral embolism in filter-protected CAS. A routine aspiration method can potentially reduce the amount of migrating debris during CAS, even in cases with angiographic normal flow.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 051834648

Download citation: RISBibTeXText

PMID: 21051513

DOI: 10.3174/ajnr.a2276

Related references

Clinical implications of internal carotid artery flow impairment caused by filter occlusion during carotid artery stenting. Ajnr. American Journal of Neuroradiology 33(3): 494-499, 2012

Comparison of dual protection and distal filter protection as a distal embolic protection method during carotid artery stenting: a single-center carotid artery stenting experience. Neurosurgical Review 38(4): 671-676, 2016

Distal flow protection during carotid stenting. a prospective study to quantify the embolic debris retrieved in the internal carotid artery territory. Interventional Neuroradiology 5 Suppl 1: 47-50, 1999

Normal reference values of ratios of blood flow velocities in internal carotid artery to those in common carotid artery using Doppler sonography. Journal of Clinical Ultrasound 37(4): 208-211, 2008

Can Doppler flow parameters of carotid stenosis predict the occurrence of new ischemic brain lesions detected by diffusion-weighted MR imaging after filter-protected internal carotid artery stenting?. Ajnr. American Journal of Neuroradiology 35(4): 760-765, 2014

Results of carotid artery stenting with distal embolic protection with improved systems: Protected Carotid Artery Stenting in Patients at High Risk for Carotid Endarterectomy (PROTECT) trial. Journal of Vascular Surgery 55(4): 968-976.E5, 2012

Case of internal carotid artery stenosis complicated with filter obstruction during carotid artery stenting with an embolus protection filter. No Shinkei Geka. Neurological Surgery 36(12): 1133-1138, 2009

Quantity, particle size, and histologic composition of embolic debris collected in a distal protection filter after carotid angioplasty and stenting: Correlation with patient characteristics, timing of carotid artery stenting, and procedural details. Journal of Thoracic and Cardiovascular Surgery 146(2): 492-495, 2013

Pulsed Doppler: an evaluation of diameter, blood velocity and blood flow of the common carotid artery in patients with isolated unilateral stenosis of the internal carotid artery. Stroke 16(6): 969-972, 1985

Rescue strategy for acute carotid stent thrombosis during carotid stenting with distal filter protection using forced arterial suction thrombectomy with a reperfusion catheter of the Penumbra System: a technical note. Acta Neurochirurgica 155(8): 1583-1588, 2014

Significance of combining distal filter protection and a guiding catheter with temporary balloon occlusion for carotid artery stenting: clinical results and evaluation of debris capture. Annals of Vascular Surgery 26(7): 929-936, 2013

Predictors of antegrade flow at internal carotid artery during carotid artery stenting with proximal protection. Acta Neurochirurgica 160(6): 1121-1127, 2018

Symptomatic carotid vasospasm caused by a distal-protection device during stent angioplasty of the right internal carotid artery. Texas Heart Institute Journal 37(2): 226-229, 2010

Combination of flow reversal and distal filter for cerebral protection during carotid artery stenting. Annals of Vascular Surgery 28(3): 651-658, 2014

Evaluation of distal extracranial internal carotid artery by transoral carotid ultrasonography in patients with severe carotid stenosis. Ajnr. American Journal of Neuroradiology 23(6): 924-928, 2002