Abstract
Objective: Carotid artery stenting (CAS) in highsurgicalrisk patients is considered as an effective alternative to carotid endarterectomy (CEA). Since the occurrence of distal embolization with CAS is still a major concern, an embolus protection device is usually employed during the procedure. We examined the debris in the embolic protection filter and compared the characteristics of the debris with the characteristics of CEA specimens.
Materials and Methods: CAS was performed for 27 patients with carotid artery stenosis (28 lesions). After completing CAS, each filter membrane was stained with HematoxylinEosin (HE) solution, removed from the filter strut, mounted onto a glass slide, and evaluated under a microscope. Fortynine patients (49 lesions) were treated with CEA. Histopathological examination was performed with HE stain, Azan stain, and Elastica van Gieson stain. The characteristics of the debris were compared with those of the CEA specimens.
Results: HE stain facilitated the characterization of the debris. Microscopically, thrombotic debris, calcified debris, lipid-rich debris, fibrous debris, cellular debris, and strips of endothelium were observed.
Conclusion: Carotid plaque debris captured during carotid stenting with a protection filter can be visualized on the filter by HE staining. Almost all components of the carotid plaque are identifiable as debris.
