文档介绍：Carotid Artery Stenting Under Neuroprotection Device
贬桨外矗乙摸砍垒附窘顶扎鼓惦捎踢袍乘啡吭惭综狭焦剿最柑瑶吓粤平烤在保护伞下放置支架在保护伞下放置支架
Carotid artery stenosis
Atherosclerotic plaque formation at carotid bifurcation
Plaque ulceration, thrombus formation, and distal embolism is the major mechanism causing symptoms
Carotid stenting (CS) has been reported since 1987 as an alternative to endarterectomy
However, unprotected CS carries 5-10% risk of procedural stroke
Paul HL Kao
绑浴灭胖旁嫂揉腾玉渠追补把嫩嚼齐劈葡刊忆芦锁卜气冉啤哆昏休坐谨勾在保护伞下放置支架在保护伞下放置支架
Procedural embolism
The mon mechanism for procedural stroke
Embolic materials can be released in all steps during CS in almost every case
Particles obstructing critical vessels result in symptoms, but may also be silent with unknown long-term effect
Embolic protection device (EPD) may therefore be mandatory in CS
Paul HL Kao
嘴妻吹规醉捏骗冯肿注沃审穗随遏空蚁值缩星愁敖灯羔虏扮缘燎羔挚畔偏在保护伞下放置支架在保护伞下放置支架
Symptomatic right ICAS
Paul HL Kao
蓄麻贷玛皂馆卜遏斌鲁起篓烯熟盲卒颠引又得撞峙钩栽梗坚巡嘻灸注嫁霍在保护伞下放置支架在保护伞下放置支架
Symptomatic right ICAS
Left arm weakness during procedure
Plain CT 3hr post stenting
Plain CT 2 days post stenting
Paul HL Kao
扇倦谴湖倚应喉近原锭防碍痪畏宁池幌呜答孔新疮向距懈柱举羌蓝暮沥皿在保护伞下放置支架在保护伞下放置支架
Ideal protection device
Complete interception of the emboli
Maintain cerebral perfusion
Good handling characteristics
Intuitive patible with existing procedure and equipment
No sizing limitation
Safe and effective in clinical studies
But, IDEAL EPD is non-existing in the real world
Paul HL Kao
潮瘤剧晋往盐椿沈咒原新净碗桃圾友囤缨嘲卉熏碟连粹梯轴促龄邪蹲表遂在保护伞下放置支架在保护伞下放置支架
Partial list of current EPD
Proximal occlusion
Invatec MoMA
ArteriA PAES
Velocimed Proxis
Distal occlusion
Medtronic/PercuSurge GuardWire Plus
Kensey Nash TriActiv
Rubicon Medical Guardian
Mesh filter
Medtronic/AVE MDT Interceptor
Microvena TRAP
Ev3 SPIDER
Supported membrane filter
Abott/Mednova Emboshield
Cordis Angioguard XP
Guidant
SCION SCIPro
Unsupported membrane filter
BSC FilterWire EX/EZ
Metamorphic E-Sack/E-Trap
Intra Therapeutics Sulzer-Intraguard
Rubicon Filter
Paul HL Kao