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Stenting for Stroke Prevention Becoming Safer
A team of researchers led by Doctor Jon Matsumura found the clinical trial PROTECT (Carotid Artery Stenting with Distal Embolic Protection with Improved System) had the lowest rate of complications ever in patients considered high risk for carotid endarterectomy (CEA)—the gold standard for opening a blocked carotid artery. Carotid artery stenosis, or the narrowing of blood vessels in the neck, is one of the leading causes of strokes in the United States.
"Recent improvements in devices designed specifically for carotid artery stenting have resulted in safer procedures and better clinical outcomes," says Matsumura. "These technological advances, combined with a stronger understanding of patient risk factors, have also improved our ability to select which patients are best suited for the less invasive procedure."
The PROTECT study was a prospective, multi-centre clinical trial designed to examine the safety of Emboshield Pro — an embolic protection device used in combination with stenting to help enlarge the blocked artery and capture any plaque that could dislodge during the process.
The study enrolled a total of 322 patients with carotid artery stenosis at 38 centres across the United States between 2006 and 2008. The first 220 patients received a stent and Emboshield Pro, while the other 102 received a stent and an older, now obsolete embolic protection device called Emboshield BareWire. Researchers tracked the composite of clinical outcomes, including death, stroke or myocardial infarction (DSMI) up to 30-days post procedure. Of the 220 who were treated with Emboshield Pro, three patients had a minor stroke (1.4 per cent), one had a major stroke (0.5 per cent), and one had a myocardial infarction (0.5 per cent), for an overall DSMI rate of 2.3 per cent, the lowest rate of complications ever recorded for the procedure in similar multicenter high-risk patient populations.
"These results are consistent with the trends from other trials, where we are seeing complication rates dropping for patients being treated with stents and embolic protection devices," Matsumura says. "This is very good news for high-risk patients suffering with carotid artery disease, who only a decade ago had limited treatment options and poor long-term outcomes."
MEDICA.de; Source: University of Wisconsin