CaRotid Artery Filtering Technique (CRAFT): A Technique for Carotid Artery Stenting with Intrinsic Embolic Protection
Purpose Carotid artery stenting (CAS) is an established treatment for symptomatic carotid artery stenosis as an alternative to carotid endarterectomy. A variety of techniques and devices have been devised to minimise periprocedural stroke risk using either proximal or distal embolic protection. This...
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| Format: | Article |
| Language: | English |
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Korean Society of Interventional Neuroradiology
2021-11-01
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| Series: | Neurointervention |
| Subjects: | |
| Online Access: | http://neurointervention.org/upload/pdf/neuroint-2021-00353.pdf |
| _version_ | 1797331735573168128 |
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| author | Michelle Foo Yifan Ren Jay Gajera Christen D Barras Hong Kuan Kok Ashu Jhamb Hussein Abbouchie Julian Maingard Duncan Mark Brooks Hamed Asadi |
| author_facet | Michelle Foo Yifan Ren Jay Gajera Christen D Barras Hong Kuan Kok Ashu Jhamb Hussein Abbouchie Julian Maingard Duncan Mark Brooks Hamed Asadi |
| author_sort | Michelle Foo |
| collection | DOAJ |
| description | Purpose Carotid artery stenting (CAS) is an established treatment for symptomatic carotid artery stenosis as an alternative to carotid endarterectomy. A variety of techniques and devices have been devised to minimise periprocedural stroke risk using either proximal or distal embolic protection. This study presents a method of embolic protection during CAS–the CaRotid Artery Filtering Technique (CRAFT). Materials and Methods The CRAFT technique employs aspects of both proximal and distal embolic protection. The CASPER RX stent (MicroVention, Tustin, CA, USA), which is a double-layered, closed-cell, micromesh nitinol stent, is deployed across the carotid artery stenosis with the assistance of a FlowGate balloon guide catheter (Stryker Neurovascular, Fremont, CA, USA). The partially deployed stent acts as a distal filter while the balloon guide is deflated midway during stent deployment to prevent distal plaque embolisation, followed by completion of stent deployment and angioplasty. Results A total of 94 patients underwent CAS using the CRAFT technique between June 2016 and March 2021. Successful stent deployment was achieved in all patients. Preliminary results demonstrated acute stent occlusion in 6 patients (6.4%) and distal embolic stroke in 5 patients (5.3%). The median procedural fluoroscopy time was 34 minutes with an interquartile range of 22 to 55 minutes. Conclusion The CRAFT technique of CAS presented by this study can be applied in the treatment of symptomatic carotid artery stenosis in both emergency and elective procedure settings with a high technical success and low distal embolic stroke risk. |
| first_indexed | 2024-03-08T07:39:38Z |
| format | Article |
| id | doaj.art-fab3478b0c064aefbd1614734ab22dd2 |
| institution | Directory Open Access Journal |
| issn | 2093-9043 2233-6273 |
| language | English |
| last_indexed | 2024-03-08T07:39:38Z |
| publishDate | 2021-11-01 |
| publisher | Korean Society of Interventional Neuroradiology |
| record_format | Article |
| series | Neurointervention |
| spelling | doaj.art-fab3478b0c064aefbd1614734ab22dd22024-02-02T17:58:06ZengKorean Society of Interventional NeuroradiologyNeurointervention2093-90432233-62732021-11-0116326026610.5469/neuroint.2021.00353349CaRotid Artery Filtering Technique (CRAFT): A Technique for Carotid Artery Stenting with Intrinsic Embolic ProtectionMichelle Foo0Yifan Ren1Jay Gajera2Christen D Barras3Hong Kuan Kok4Ashu Jhamb5Hussein Abbouchie6Julian Maingard7Duncan Mark Brooks8Hamed Asadi9 Department of Radiology, Austin Hospital, Melbourne, Vic, Australia Department of Radiology, Austin Hospital, Melbourne, Vic, Australia Department of Radiology, Alfred Health, Melbourne, Vic, Australia South Australian Health and Medical Research Institute, University of Adelaide, Adelaide, SA, Australia Interventional Radiology Service, Department of Radiology, Northern Health, Melbourne, Vic, Australia Interventional Radiology Service, Department of Radiology, St Vincent’s Hospital, Melbourne, Vic, Australia Department of Radiology, Austin Hospital, Melbourne, Vic, Australia School of Medicine, Faculty of Health, Deakin University, Waurn Ponds, Vic, Australia Department of Radiology, Austin Hospital, Melbourne, Vic, Australia Department of Radiology, Austin Hospital, Melbourne, Vic, AustraliaPurpose Carotid artery stenting (CAS) is an established treatment for symptomatic carotid artery stenosis as an alternative to carotid endarterectomy. A variety of techniques and devices have been devised to minimise periprocedural stroke risk using either proximal or distal embolic protection. This study presents a method of embolic protection during CAS–the CaRotid Artery Filtering Technique (CRAFT). Materials and Methods The CRAFT technique employs aspects of both proximal and distal embolic protection. The CASPER RX stent (MicroVention, Tustin, CA, USA), which is a double-layered, closed-cell, micromesh nitinol stent, is deployed across the carotid artery stenosis with the assistance of a FlowGate balloon guide catheter (Stryker Neurovascular, Fremont, CA, USA). The partially deployed stent acts as a distal filter while the balloon guide is deflated midway during stent deployment to prevent distal plaque embolisation, followed by completion of stent deployment and angioplasty. Results A total of 94 patients underwent CAS using the CRAFT technique between June 2016 and March 2021. Successful stent deployment was achieved in all patients. Preliminary results demonstrated acute stent occlusion in 6 patients (6.4%) and distal embolic stroke in 5 patients (5.3%). The median procedural fluoroscopy time was 34 minutes with an interquartile range of 22 to 55 minutes. Conclusion The CRAFT technique of CAS presented by this study can be applied in the treatment of symptomatic carotid artery stenosis in both emergency and elective procedure settings with a high technical success and low distal embolic stroke risk.http://neurointervention.org/upload/pdf/neuroint-2021-00353.pdfcarotid arteriesstentsradiologyinterventional |
| spellingShingle | Michelle Foo Yifan Ren Jay Gajera Christen D Barras Hong Kuan Kok Ashu Jhamb Hussein Abbouchie Julian Maingard Duncan Mark Brooks Hamed Asadi CaRotid Artery Filtering Technique (CRAFT): A Technique for Carotid Artery Stenting with Intrinsic Embolic Protection Neurointervention carotid arteries stents radiology interventional |
| title | CaRotid Artery Filtering Technique (CRAFT): A Technique for Carotid Artery Stenting with Intrinsic Embolic Protection |
| title_full | CaRotid Artery Filtering Technique (CRAFT): A Technique for Carotid Artery Stenting with Intrinsic Embolic Protection |
| title_fullStr | CaRotid Artery Filtering Technique (CRAFT): A Technique for Carotid Artery Stenting with Intrinsic Embolic Protection |
| title_full_unstemmed | CaRotid Artery Filtering Technique (CRAFT): A Technique for Carotid Artery Stenting with Intrinsic Embolic Protection |
| title_short | CaRotid Artery Filtering Technique (CRAFT): A Technique for Carotid Artery Stenting with Intrinsic Embolic Protection |
| title_sort | carotid artery filtering technique craft a technique for carotid artery stenting with intrinsic embolic protection |
| topic | carotid arteries stents radiology interventional |
| url | http://neurointervention.org/upload/pdf/neuroint-2021-00353.pdf |
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