Embolic Protection with Stenting Safer than Endarterectomy

A study has shown that carotid artery stenting (CAS) with a new embolic protection system is a safer alternative for high-risk surgical patients than carotid endarterectomy (CEA). The results were presented at the 2002 Scientific Sessions of the American Heart Association.

Of the 307 patients in the randomized arm of the study, 156 received a nitinol self-expanding stent in combination with the embolic protection system. The remaining patients underwent CEA. At 30-day follow-up, the major adverse event rate for the stented group was 5.8% versus 12.6% for the CEA group.

When deployed, the embolic protection system, called Angioguard XP Emboli Capture Guidewire, opens a tiny protective basket designed to catch plaque particles that may be dislodged during the stenting procedure and cause a stroke. In the study, more than 60% of the baskets contained embolized debris upon retrieval, indicating that the system was providing protection. The system is the product of Cordis Vascular, a division of Cordis Corp., a Johnson & Johnson company (New Brunswick, NJ, USA; www.jnj.com).

"While these results are preliminary, the 30-day data are a good barometer of long-term results,” said Jay Yadav, M.D., director of vascular intervention at the Cleveland Clinic Foundation (OH, USA) and one of the study's investigators. "Most procedure-related adverse events in carotid artery intervention occur within this time frame.”




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