Abstract
Background: The incidence of atherosclerotic carotid artery stenosis is increasing in Japan. Here we report on the effectiveness of the balloon distal protection carotid artery stenting (CAS) method using an autologous aspirated blood transfusion from the carotid artery during treatment.
Method: Between November 2007 and July 2014, 218 patients (233 lesions) diagnosed with carotid artery stenosis were treated with CAS in our institute. We divided these patients into four groups stratified by protection device and intervention date. The four groups were defined as: ANGIOGUARD (AG) (intervention from Nov 2007 to May 2010), Filter Wire (FW) (June 2010 to Nov 2011), PercuSurge GuardWire (PS) (Dec 2011 to Sept 2012), and self-transfused blood combined with PS (SB) (Oct 2012 to July 2014). We reviewed the diffusion-weighted imaging (DWI) positivity rate and ipsilateral ischemic events for a period of 30 days post-intervention.
Results: Transient ischemic attack occurred in four patients, but there were no long-term sequelae in patients treated with the AG and the DWI positivity rate was 64.0%. Two cases of retinal ischemia and one of a minor completed stroke were recorded for those treated with the FW, and the DWI positivity rate was 20.4%. Retinal ischemia occurred in one patient treated with the PS and the DWI positivity rate was 47.8%. In those patients treated with autologous blood transfusion and SB, there were no observed ischemic complications and the DWI positivity rate was 17.8%.
Conclusion: The combined method of autologous blood transfusion and the PS balloon protection device is more effective and safer than CAS combined with other protection methods.
