Objective: To report the clinical outcomes of carotid artery stenting (CAS) using the FilterWire EZ (FWEZ) Embolic Protection System.
Methods: In 262 consecutive patients who underwent CAS using FWEZ from May 2010 to December 31, 2015, major adverse events (MAEs) including stroke, myocardial infarction, and death that occurred between 30 days and 1 year after the procedure and findings on diffusion-weighted imaging (DWI) were evaluated.
Results: Ischemic stroke was observed after CAS using FWEZ in four patients (1.53%), but the neurological symptoms disappeared within 30 days in all those patients. No cerebral hemorrhage, myocardial infarction, or death occurred within 30 days after CAS. New DWI lesions were observed in 53 patients (20.2%): ipsilateral hemisphere alone in 38 patients (14.5%), contralateral hemisphere alone in 5 patients (1.9%), and both hemispheres in 10 patients (3.82%). They were significantly related to age, smoking within 1 year, and prolonged post-procedural hypotension. In 235 patients who could be followed up, no ipsilateral stroke was noted between 31 days and 1 year after CAS. Non-ipsilateral strokes were observed in three patients (1.28%): contralateral cerebral infarction in one patient (0.43%), contralateral cerebral hemorrhage in one patient (0.43%), and death due to subarachnoid hemorrhage in one patient (0.43%). Other events included non-traumatic acute subdural hematoma in one patient (0.43%), myocardial infarction in six patients (2.55%), and death in seven patients (2.98%). No 50% or severer stenosis was observed within 1 year.
Conclusion: The clinical outcomes and DWI-positive rates between 30 days and 1 year after CAS using FWEZ were favorable. CAS using FWEZ is a simple procedure and is considered effective for the treatment of carotid stenosis considered.