Symptomatic patients have similar outcomes compared with asymptomatic patients after carotid artery stenting with emboli protection.

In a single-center cohort of 174 consecutive patients, we sought to evaluate whether the use of emboli protection devices (EPDs) results in equivalent rates of adverse events in symptomatic and asymptomatic patients after carotid artery stenting (CAS) with EPDs. Death or stroke occurred in 3.3% in the symptomatic group and in 3.5% of the asymptomatic group at 30 days (p = NS). At 6 months, there was also no significant difference in the rate of stroke or death between the groups. Unlike surgical revascularization, symptomatic patients did not have a greater risk for stroke and death compared with asymptomatic patients after CAS with EPDs.

[1]  S S Iyer,et al.  Effect of the Distal-Balloon Protection System on Microembolization During Carotid Stenting , 2001, Circulation.

[2]  Risk Factors for Death or Stroke After Carotid Endarterectomy: Observations From the Ontario Carotid Endarterectomy Registry , 2003 .

[3]  J. Slattery,et al.  A systematic comparison of the risks of stroke and death due to carotid endarterectomy for symptomatic and asymptomatic stenosis. , 1996, Stroke.

[4]  J. Toole,et al.  Guidelines for carotid endarterectomy: a statement for healthcare professionals from a special writing group of the Stroke Council, American Heart Association. , 1998, Stroke.

[5]  E. Investigators.  Carotid Angioplasty and Stenting With and Without Cerebral Protection: Clinical Alert From the Endarterectomy Versus Angioplasty in Patients With Symptomatic Severe Carotid Stenosis (EVA-3S) Trial , 2004 .

[6]  F. Setacci,et al.  Protected Carotid Stenting: Clinical Advantages and Complications of Embolic Protection Devices in 442 Consecutive Patients , 2003, Stroke.

[7]  Andreas Kastrup,et al.  Early Outcome of Carotid Angioplasty and Stenting With and Without Cerebral Protection Devices: A Systematic Review of the Literature , 2003, Stroke.

[8]  Immediate and Late Clinical Outcomes of Carotid Artery Stenting in Patients With Symptomatic and Asymptomatic Carotid Artery Stenosis A 5-Year Prospective Analysis , 2001 .

[9]  J. Toole,et al.  Carotid endarterectomy: practice guidelines. Report of the Ad Hoc Committee to the Joint Council of the Society for Vascular Surgery and the North American Chapter of the International Society for Cardiovascular Surgery. , 1992, Journal of vascular surgery.

[10]  J. Schofer,et al.  Focal ischemia of the brain after neuroprotected carotid artery stenting. , 2003, Journal of the American College of Cardiology.

[11]  A H Davies,et al.  The symptomatic carotid plaque. , 2000, Stroke.

[12]  A. Davies,et al.  Endarterectomy for asymptomatic carotid artery stenosis , 1995, BMJ.

[13]  C. Liapis,et al.  Carotid Stenosis: Factors Affecting Symptomatology , 2001, Stroke.

[14]  W. Jordan,et al.  Microemboli detected by transcranial Doppler monitoring in patients during carotid angioplasty versus carotid endarterectomy. , 1999, Cardiovascular surgery.

[15]  D. Sackett,et al.  Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. , 1991, The New England journal of medicine.

[16]  V Larrue,et al.  Microembolic signals and risk of early recurrence in patients with stroke or transient ischemic attack. , 1998, Stroke.

[17]  U Kaul,et al.  Elective stenting of extracranial carotid arteries. , 1997, The Journal of the Association of Physicians of India.

[18]  G. Donnan,et al.  Source of Microembolic Signals in Patients With High-Grade Carotid Stenosis , 2002, Stroke.

[19]  Mark H Wholey,et al.  Updated review of the global carotid artery stent registry , 2003, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[20]  Hobson Rw nd.  CREST (Carotid Revascularization Endarterectomy versus Stent Trial): background, design, and current status. , 2000 .