The safety and efficacy of the Mo.Ma system device for carotid artery stenting: A single-center experience from Taiwan
BackgroundProximal protection devices, such as the Mo.Ma system provides better neurological outcomes than the distal filter system in the carotid artery stenting (CAS) procedure. This study first evaluated the safety and efficacy of the Mo.Ma system during CAS in a single tertiary referral hospital...
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Frontiers Media S.A.
2022-09-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.926513/full |
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| author | Cheng-Chung Cheng Chin-Sheng Lin Wei-Hsian Yin Wei-Hsian Yin Chin Lin Chin Lin I-Fan Liu I-Fan Liu Yu-Feng Lee Wei-Ting Liu Hao-Neng Fu Chien-Lung Huang Chien-Lung Huang Tien-Ping Tsao Tien-Ping Tsao |
| author_facet | Cheng-Chung Cheng Chin-Sheng Lin Wei-Hsian Yin Wei-Hsian Yin Chin Lin Chin Lin I-Fan Liu I-Fan Liu Yu-Feng Lee Wei-Ting Liu Hao-Neng Fu Chien-Lung Huang Chien-Lung Huang Tien-Ping Tsao Tien-Ping Tsao |
| author_sort | Cheng-Chung Cheng |
| collection | DOAJ |
| description | BackgroundProximal protection devices, such as the Mo.Ma system provides better neurological outcomes than the distal filter system in the carotid artery stenting (CAS) procedure. This study first evaluated the safety and efficacy of the Mo.Ma system during CAS in a single tertiary referral hospital from Taiwan. The outcomes of distal vs. proximal embolic protection devices were also studied.MethodsA total of 294 patients with carotid artery stenosis who underwent the CAS procedure were retrospectively included and divided into two groups: 152 patients in the distal filter system group and 142 patients in the Mo.Ma system. The outcomes of interest were compared between the two groups. The factors contributing to occlusion intolerance (OI) in the Mo.Ma system were evaluated.ResultsThe procedure success rates were more than 98% in both groups. No major stroke occurred in this study. The minor stroke rates were 2.8% (4/142) and 4.6% (7/152) in the Mo.Ma system and filter system, respectively (p = 0.419). Patients with hypoalbuminemia significantly predicted the risk of stroke with an odds ratio of 0.08 [95% confidence interval (CI), 0.01–0.68, p = 0.020] per 1 g/day of serum albumin in the filter group. A total of 12 patients developed OI in the Mo.Ma system (12/142, 8%). Low occlusion pressure predicted the occurrence of OI in the Mo.Ma group with the hazard ratios of 0.88 (95% CI: 0.82–0.96) and 0.90 (95% CI: 0.84–0.98) per 1 mmHg of occlusion systolic pressure (OSP) and diastolic pressure (ODP), respectively. We further indicated that patients with an OSP of ≥60 mmHg or an ODP of ≥44 mmHg could tolerate the procedure of occlusion time up to 400 s, while patients with an OSP of <49 mmHg or an ODP of <34 mmHg should undergo the procedure of occlusion time less than 300 s to prevent the occurrence of OI.ConclusionWe have demonstrated the safety and effectiveness of the Mo.Ma system during CAS in an Asia population. By reducing the occlusion time, our study indicated a lower risk of OI in the Mo.Ma system and proposed the optimal occlusion time according to occlusion pressure to prevent OI during the CAS procedure. Further large-scale and prospective studies are needed to verify our results. |
| first_indexed | 2024-04-11T09:59:59Z |
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| institution | Directory Open Access Journal |
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| language | English |
| last_indexed | 2024-04-11T09:59:59Z |
| publishDate | 2022-09-01 |
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| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-d5fc4891f7304515af537f2b778911a72022-12-22T04:30:27ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-09-01910.3389/fcvm.2022.926513926513The safety and efficacy of the Mo.Ma system device for carotid artery stenting: A single-center experience from TaiwanCheng-Chung Cheng0Chin-Sheng Lin1Wei-Hsian Yin2Wei-Hsian Yin3Chin Lin4Chin Lin5I-Fan Liu6I-Fan Liu7Yu-Feng Lee8Wei-Ting Liu9Hao-Neng Fu10Chien-Lung Huang11Chien-Lung Huang12Tien-Ping Tsao13Tien-Ping Tsao14Division of Cardiology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, TaiwanDivision of Cardiology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, TaiwanDivision of Cardiology, Heart Center, Cheng Hsin General Hospital, Taipei, TaiwanFaculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, TaiwanSchool of Public Health, National Defense Medical Center, Taipei, TaiwanSchool of Medicine, National Defense Medical Center, Taipei, TaiwanDivision of Cardiology, Heart Center, Cheng Hsin General Hospital, Taipei, TaiwanInstitute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, TaiwanSchool of Medicine, National Defense Medical Center, Taipei, TaiwanDivision of Cardiology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, TaiwanDivision of Cardiology, Heart Center, Cheng Hsin General Hospital, Taipei, TaiwanDivision of Cardiology, Heart Center, Cheng Hsin General Hospital, Taipei, TaiwanFaculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, TaiwanDivision of Cardiology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, TaiwanDivision of Cardiology, Heart Center, Cheng Hsin General Hospital, Taipei, TaiwanBackgroundProximal protection devices, such as the Mo.Ma system provides better neurological outcomes than the distal filter system in the carotid artery stenting (CAS) procedure. This study first evaluated the safety and efficacy of the Mo.Ma system during CAS in a single tertiary referral hospital from Taiwan. The outcomes of distal vs. proximal embolic protection devices were also studied.MethodsA total of 294 patients with carotid artery stenosis who underwent the CAS procedure were retrospectively included and divided into two groups: 152 patients in the distal filter system group and 142 patients in the Mo.Ma system. The outcomes of interest were compared between the two groups. The factors contributing to occlusion intolerance (OI) in the Mo.Ma system were evaluated.ResultsThe procedure success rates were more than 98% in both groups. No major stroke occurred in this study. The minor stroke rates were 2.8% (4/142) and 4.6% (7/152) in the Mo.Ma system and filter system, respectively (p = 0.419). Patients with hypoalbuminemia significantly predicted the risk of stroke with an odds ratio of 0.08 [95% confidence interval (CI), 0.01–0.68, p = 0.020] per 1 g/day of serum albumin in the filter group. A total of 12 patients developed OI in the Mo.Ma system (12/142, 8%). Low occlusion pressure predicted the occurrence of OI in the Mo.Ma group with the hazard ratios of 0.88 (95% CI: 0.82–0.96) and 0.90 (95% CI: 0.84–0.98) per 1 mmHg of occlusion systolic pressure (OSP) and diastolic pressure (ODP), respectively. We further indicated that patients with an OSP of ≥60 mmHg or an ODP of ≥44 mmHg could tolerate the procedure of occlusion time up to 400 s, while patients with an OSP of <49 mmHg or an ODP of <34 mmHg should undergo the procedure of occlusion time less than 300 s to prevent the occurrence of OI.ConclusionWe have demonstrated the safety and effectiveness of the Mo.Ma system during CAS in an Asia population. By reducing the occlusion time, our study indicated a lower risk of OI in the Mo.Ma system and proposed the optimal occlusion time according to occlusion pressure to prevent OI during the CAS procedure. Further large-scale and prospective studies are needed to verify our results.https://www.frontiersin.org/articles/10.3389/fcvm.2022.926513/fullproximal protection devicecarotid artery stentingstrokecarotid stenosisocclusion intolerance |
| spellingShingle | Cheng-Chung Cheng Chin-Sheng Lin Wei-Hsian Yin Wei-Hsian Yin Chin Lin Chin Lin I-Fan Liu I-Fan Liu Yu-Feng Lee Wei-Ting Liu Hao-Neng Fu Chien-Lung Huang Chien-Lung Huang Tien-Ping Tsao Tien-Ping Tsao The safety and efficacy of the Mo.Ma system device for carotid artery stenting: A single-center experience from Taiwan Frontiers in Cardiovascular Medicine proximal protection device carotid artery stenting stroke carotid stenosis occlusion intolerance |
| title | The safety and efficacy of the Mo.Ma system device for carotid artery stenting: A single-center experience from Taiwan |
| title_full | The safety and efficacy of the Mo.Ma system device for carotid artery stenting: A single-center experience from Taiwan |
| title_fullStr | The safety and efficacy of the Mo.Ma system device for carotid artery stenting: A single-center experience from Taiwan |
| title_full_unstemmed | The safety and efficacy of the Mo.Ma system device for carotid artery stenting: A single-center experience from Taiwan |
| title_short | The safety and efficacy of the Mo.Ma system device for carotid artery stenting: A single-center experience from Taiwan |
| title_sort | safety and efficacy of the mo ma system device for carotid artery stenting a single center experience from taiwan |
| topic | proximal protection device carotid artery stenting stroke carotid stenosis occlusion intolerance |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.926513/full |
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