Abstract T P101: Incidence of Dissection and Vasospasm Related to Distal Embolic Protection Devices During Elective Carotid Artery Stenting: 5 Year Retrospective Review

Abstract

Hypothesis: •We assessed the hypothesis that the Abbott Vascular Nav6 DEP, was associated with the lowest risk of dissection and vasospasm. •Identify the overall incidence of vasospasm and dissection associated with distal embolic protection device during elective carotid artery stenting BACKGROUND: •Carotid angioplasty and stenting has been show to have an increased risk of embolic stroke compared to carotid endarterectomy. To minimize this risk, distal embolic protection devices are considered the standard of care for all carotid stenting procedures. • At Christiana Care Health System over 225 carotid stents have been placed in the last 5 years. • No prior study has compared distal embolic protection devices to determine which were associated with lower complication rates. Methods: •Electronic query of all carotid stenting procedures was performed between 1/2/2009 and 12/30/13; total of 244 patients included Results: • Distal embolic protection devices were associated with angiographic vasospasm in 31% and dissection in less than 1% of patients. The Nav 6 device was found to associated with the lowest incidence of vasospasm and no dissections. Discussion: • Research that improves equipment or techniques during carotid artery stenting should be aggressively pursued to further improve clinical outcomes and reduce the risk of procedural complications. Conclusion: On the basis of this single center retrospective five year analysis, the Abbott Vascular Nav 6 distal embolic device was associated with the lowest incidences of vasospasm. Clinical Implications: • More research and study of complications associated with distal embolic protection devices is warranted. This may lead to a lower complication rate in elective carotid artery stenting