Comparing the embolic potential of open and closed cell stents during carotid angioplasty and stenting

Rami O. Tadros, Constantinos T. Spyris, Ageliki G. Vouyouka, Christine Chung, Prakash Krishnan, Margaret Walkup Arnold, Michael L. Marin, Peter L. Faries

Research output: Contribution to journalArticle

Abstract

Objective: We sought to determine the effects of open (O) and closed (C) cell stents on the size and number of embolic particles generated during carotid artery stenting (CAS) and assess the impact on outcome. Methods: Embolic debris from carotid filters after CAS was analyzed using photomicroscopy and imaging software. Patient comorbidities, preoperative cerebrovascular symptoms, stent type, and outcomes (perioperative major adverse events) were examined. Results: Carotid filters from 173 consecutive CAS procedures (O, 125 and C, 48) were reviewed. The mean age was 70.9 ± 9.2 years; 58% were men. Mean stenosis was 88.2% ± 8.1%; 36.6% had neurological symptoms preprocedurally. There was no difference in preoperative symptoms between the two groups (O, 38.7% vs C, 31.3%; P = not significant [NS]). However, closed cell stent use was associated with higher degree of stenosis (O, 87.2% ± 8.0% vs C, 90.6% ± 7.8%; P =.01), an older age (O, 70.0 ± 8.6 years vs C, 73.4 ± 10.2 years; P =.03), and peripheral arterial disease (21.1% vs 43.5%; P =.01). A larger mean particle size was observed in patients treated with open cell stents compared to closed cell stents (O, 416.5 ± 335.7 μm vs C, 301.1 ± 251.3 μm; P =.03). There was no significant difference in the total number of particles (O, 13.8 ± 21.5 vs C, 17.6 ± 19.9; P = NS), periprocedural stroke (P = NS), and major adverse events between the two groups (P = NS). Conclusions: Open cell stents are associated with a larger mean particle size compared to closed cell stents. No impact on procedural outcomes based on stent type was observed.

Original languageEnglish (US)
Pages (from-to)89-95
Number of pages7
JournalJournal of Vascular Surgery
Volume56
Issue number1
DOIs
StatePublished - Jul 2012

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Angioplasty
Stents
Carotid Arteries
Particle Size
Pathologic Constriction
Peripheral Arterial Disease
Comorbidity
Software
Stroke

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Comparing the embolic potential of open and closed cell stents during carotid angioplasty and stenting. / Tadros, Rami O.; Spyris, Constantinos T.; Vouyouka, Ageliki G.; Chung, Christine; Krishnan, Prakash; Arnold, Margaret Walkup; Marin, Michael L.; Faries, Peter L.

In: Journal of Vascular Surgery, Vol. 56, No. 1, 07.2012, p. 89-95.

Research output: Contribution to journalArticle

Tadros, RO, Spyris, CT, Vouyouka, AG, Chung, C, Krishnan, P, Arnold, MW, Marin, ML & Faries, PL 2012, 'Comparing the embolic potential of open and closed cell stents during carotid angioplasty and stenting', Journal of Vascular Surgery, vol. 56, no. 1, pp. 89-95. https://doi.org/10.1016/j.jvs.2011.12.077
Tadros, Rami O. ; Spyris, Constantinos T. ; Vouyouka, Ageliki G. ; Chung, Christine ; Krishnan, Prakash ; Arnold, Margaret Walkup ; Marin, Michael L. ; Faries, Peter L. / Comparing the embolic potential of open and closed cell stents during carotid angioplasty and stenting. In: Journal of Vascular Surgery. 2012 ; Vol. 56, No. 1. pp. 89-95.
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abstract = "Objective: We sought to determine the effects of open (O) and closed (C) cell stents on the size and number of embolic particles generated during carotid artery stenting (CAS) and assess the impact on outcome. Methods: Embolic debris from carotid filters after CAS was analyzed using photomicroscopy and imaging software. Patient comorbidities, preoperative cerebrovascular symptoms, stent type, and outcomes (perioperative major adverse events) were examined. Results: Carotid filters from 173 consecutive CAS procedures (O, 125 and C, 48) were reviewed. The mean age was 70.9 ± 9.2 years; 58{\%} were men. Mean stenosis was 88.2{\%} ± 8.1{\%}; 36.6{\%} had neurological symptoms preprocedurally. There was no difference in preoperative symptoms between the two groups (O, 38.7{\%} vs C, 31.3{\%}; P = not significant [NS]). However, closed cell stent use was associated with higher degree of stenosis (O, 87.2{\%} ± 8.0{\%} vs C, 90.6{\%} ± 7.8{\%}; P =.01), an older age (O, 70.0 ± 8.6 years vs C, 73.4 ± 10.2 years; P =.03), and peripheral arterial disease (21.1{\%} vs 43.5{\%}; P =.01). A larger mean particle size was observed in patients treated with open cell stents compared to closed cell stents (O, 416.5 ± 335.7 μm vs C, 301.1 ± 251.3 μm; P =.03). There was no significant difference in the total number of particles (O, 13.8 ± 21.5 vs C, 17.6 ± 19.9; P = NS), periprocedural stroke (P = NS), and major adverse events between the two groups (P = NS). Conclusions: Open cell stents are associated with a larger mean particle size compared to closed cell stents. No impact on procedural outcomes based on stent type was observed.",
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AU - Tadros, Rami O.

AU - Spyris, Constantinos T.

AU - Vouyouka, Ageliki G.

AU - Chung, Christine

AU - Krishnan, Prakash

AU - Arnold, Margaret Walkup

AU - Marin, Michael L.

AU - Faries, Peter L.

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N2 - Objective: We sought to determine the effects of open (O) and closed (C) cell stents on the size and number of embolic particles generated during carotid artery stenting (CAS) and assess the impact on outcome. Methods: Embolic debris from carotid filters after CAS was analyzed using photomicroscopy and imaging software. Patient comorbidities, preoperative cerebrovascular symptoms, stent type, and outcomes (perioperative major adverse events) were examined. Results: Carotid filters from 173 consecutive CAS procedures (O, 125 and C, 48) were reviewed. The mean age was 70.9 ± 9.2 years; 58% were men. Mean stenosis was 88.2% ± 8.1%; 36.6% had neurological symptoms preprocedurally. There was no difference in preoperative symptoms between the two groups (O, 38.7% vs C, 31.3%; P = not significant [NS]). However, closed cell stent use was associated with higher degree of stenosis (O, 87.2% ± 8.0% vs C, 90.6% ± 7.8%; P =.01), an older age (O, 70.0 ± 8.6 years vs C, 73.4 ± 10.2 years; P =.03), and peripheral arterial disease (21.1% vs 43.5%; P =.01). A larger mean particle size was observed in patients treated with open cell stents compared to closed cell stents (O, 416.5 ± 335.7 μm vs C, 301.1 ± 251.3 μm; P =.03). There was no significant difference in the total number of particles (O, 13.8 ± 21.5 vs C, 17.6 ± 19.9; P = NS), periprocedural stroke (P = NS), and major adverse events between the two groups (P = NS). Conclusions: Open cell stents are associated with a larger mean particle size compared to closed cell stents. No impact on procedural outcomes based on stent type was observed.

AB - Objective: We sought to determine the effects of open (O) and closed (C) cell stents on the size and number of embolic particles generated during carotid artery stenting (CAS) and assess the impact on outcome. Methods: Embolic debris from carotid filters after CAS was analyzed using photomicroscopy and imaging software. Patient comorbidities, preoperative cerebrovascular symptoms, stent type, and outcomes (perioperative major adverse events) were examined. Results: Carotid filters from 173 consecutive CAS procedures (O, 125 and C, 48) were reviewed. The mean age was 70.9 ± 9.2 years; 58% were men. Mean stenosis was 88.2% ± 8.1%; 36.6% had neurological symptoms preprocedurally. There was no difference in preoperative symptoms between the two groups (O, 38.7% vs C, 31.3%; P = not significant [NS]). However, closed cell stent use was associated with higher degree of stenosis (O, 87.2% ± 8.0% vs C, 90.6% ± 7.8%; P =.01), an older age (O, 70.0 ± 8.6 years vs C, 73.4 ± 10.2 years; P =.03), and peripheral arterial disease (21.1% vs 43.5%; P =.01). A larger mean particle size was observed in patients treated with open cell stents compared to closed cell stents (O, 416.5 ± 335.7 μm vs C, 301.1 ± 251.3 μm; P =.03). There was no significant difference in the total number of particles (O, 13.8 ± 21.5 vs C, 17.6 ± 19.9; P = NS), periprocedural stroke (P = NS), and major adverse events between the two groups (P = NS). Conclusions: Open cell stents are associated with a larger mean particle size compared to closed cell stents. No impact on procedural outcomes based on stent type was observed.

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