Initial experience with a reversal-of-flow cerebral protection device in carotid angioplasty
Autor(a) principal: | |
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Data de Publicação: | 2013 |
Outros Autores: | , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Jornal Vascular Brasileiro (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-54492013000100005 |
Resumo: | PURPOSE: To report initial findings with the GORE Flow Reversal System®, with a focus on major/minor adverse events in the 30 first postoperative days. METHODS: The first 24 patients submitted to carotid angioplasty using the GORE system, from June 2010 to May 2012, were retrospectively assessed with regard to indications, anatomic details, technical difficulties, and early clinical outcomes, including major (stroke, death, acute myocardial infarction) and minor (hematoma) adverse events. RESULTS: Systemic hypertension was present in 100% of the patients, diabetes mellitus in 58.3%, and coronary disease in 37.5%. Type II aortic arch was encountered in 62.5% of the patients and atherosclerotic lesion predominantly at the carotid bifurcation affecting the internal and common carotid arteries in 79.2%. Angiographic data revealed contralateral carotid arteries with <50% stenosis in 95.8% of cases and preservation of cerebral blood flow in 95.8%. All procedures but one were technically successful. Mean cerebral flow reversal time was 14.9 minutes, with a statistically significant difference between the first 12 (17.9 minutes) and the last 12 patients treated (11.6 minutes) (p<0.001). Intolerance to flow reversal was observed in 17.4% of the cases. Technical difficulties were experienced in 1 patient (4.2%). Clinical outcomes included 4.2% of stroke and 12.5% of hematomas at arterial puncture sites. CONCLUSION: The system was technically effective. A significant reduction in cerebral flow reversal time was observed, and the rates of early major/minor adverse events were within acceptable limits, suggesting that the device is safe and effective. |
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Initial experience with a reversal-of-flow cerebral protection device in carotid angioplastyangioplastycerebral protectioncomplicationsPURPOSE: To report initial findings with the GORE Flow Reversal System®, with a focus on major/minor adverse events in the 30 first postoperative days. METHODS: The first 24 patients submitted to carotid angioplasty using the GORE system, from June 2010 to May 2012, were retrospectively assessed with regard to indications, anatomic details, technical difficulties, and early clinical outcomes, including major (stroke, death, acute myocardial infarction) and minor (hematoma) adverse events. RESULTS: Systemic hypertension was present in 100% of the patients, diabetes mellitus in 58.3%, and coronary disease in 37.5%. Type II aortic arch was encountered in 62.5% of the patients and atherosclerotic lesion predominantly at the carotid bifurcation affecting the internal and common carotid arteries in 79.2%. Angiographic data revealed contralateral carotid arteries with <50% stenosis in 95.8% of cases and preservation of cerebral blood flow in 95.8%. All procedures but one were technically successful. Mean cerebral flow reversal time was 14.9 minutes, with a statistically significant difference between the first 12 (17.9 minutes) and the last 12 patients treated (11.6 minutes) (p<0.001). Intolerance to flow reversal was observed in 17.4% of the cases. Technical difficulties were experienced in 1 patient (4.2%). Clinical outcomes included 4.2% of stroke and 12.5% of hematomas at arterial puncture sites. CONCLUSION: The system was technically effective. A significant reduction in cerebral flow reversal time was observed, and the rates of early major/minor adverse events were within acceptable limits, suggesting that the device is safe and effective.Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV)2013-03-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-54492013000100005Jornal Vascular Brasileiro v.12 n.1 2013reponame:Jornal Vascular Brasileiro (Online)instname:Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV)instacron:SBACV10.1590/S1677-54492013000100005info:eu-repo/semantics/openAccessGalego,Sidnei JoséColli Junior,Dino FecciDonatelli,ReinaldoCardoso,Marcos Antonio PereiraBueno,Anderson NadiakLobato,Armando Carvalho deCorrêa,João AntonioGoldman,Salomãoeng2013-04-03T00:00:00Zoai:scielo:S1677-54492013000100005Revistahttp://www.scielo.br/jvbhttps://old.scielo.br/oai/scielo-oai.php||secretaria@sbacv.org.br1677-73011677-5449opendoar:2013-04-03T00:00Jornal Vascular Brasileiro (Online) - Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV)false |
dc.title.none.fl_str_mv |
Initial experience with a reversal-of-flow cerebral protection device in carotid angioplasty |
title |
Initial experience with a reversal-of-flow cerebral protection device in carotid angioplasty |
spellingShingle |
Initial experience with a reversal-of-flow cerebral protection device in carotid angioplasty Galego,Sidnei José angioplasty cerebral protection complications |
title_short |
Initial experience with a reversal-of-flow cerebral protection device in carotid angioplasty |
title_full |
Initial experience with a reversal-of-flow cerebral protection device in carotid angioplasty |
title_fullStr |
Initial experience with a reversal-of-flow cerebral protection device in carotid angioplasty |
title_full_unstemmed |
Initial experience with a reversal-of-flow cerebral protection device in carotid angioplasty |
title_sort |
Initial experience with a reversal-of-flow cerebral protection device in carotid angioplasty |
author |
Galego,Sidnei José |
author_facet |
Galego,Sidnei José Colli Junior,Dino Fecci Donatelli,Reinaldo Cardoso,Marcos Antonio Pereira Bueno,Anderson Nadiak Lobato,Armando Carvalho de Corrêa,João Antonio Goldman,Salomão |
author_role |
author |
author2 |
Colli Junior,Dino Fecci Donatelli,Reinaldo Cardoso,Marcos Antonio Pereira Bueno,Anderson Nadiak Lobato,Armando Carvalho de Corrêa,João Antonio Goldman,Salomão |
author2_role |
author author author author author author author |
dc.contributor.author.fl_str_mv |
Galego,Sidnei José Colli Junior,Dino Fecci Donatelli,Reinaldo Cardoso,Marcos Antonio Pereira Bueno,Anderson Nadiak Lobato,Armando Carvalho de Corrêa,João Antonio Goldman,Salomão |
dc.subject.por.fl_str_mv |
angioplasty cerebral protection complications |
topic |
angioplasty cerebral protection complications |
description |
PURPOSE: To report initial findings with the GORE Flow Reversal System®, with a focus on major/minor adverse events in the 30 first postoperative days. METHODS: The first 24 patients submitted to carotid angioplasty using the GORE system, from June 2010 to May 2012, were retrospectively assessed with regard to indications, anatomic details, technical difficulties, and early clinical outcomes, including major (stroke, death, acute myocardial infarction) and minor (hematoma) adverse events. RESULTS: Systemic hypertension was present in 100% of the patients, diabetes mellitus in 58.3%, and coronary disease in 37.5%. Type II aortic arch was encountered in 62.5% of the patients and atherosclerotic lesion predominantly at the carotid bifurcation affecting the internal and common carotid arteries in 79.2%. Angiographic data revealed contralateral carotid arteries with <50% stenosis in 95.8% of cases and preservation of cerebral blood flow in 95.8%. All procedures but one were technically successful. Mean cerebral flow reversal time was 14.9 minutes, with a statistically significant difference between the first 12 (17.9 minutes) and the last 12 patients treated (11.6 minutes) (p<0.001). Intolerance to flow reversal was observed in 17.4% of the cases. Technical difficulties were experienced in 1 patient (4.2%). Clinical outcomes included 4.2% of stroke and 12.5% of hematomas at arterial puncture sites. CONCLUSION: The system was technically effective. A significant reduction in cerebral flow reversal time was observed, and the rates of early major/minor adverse events were within acceptable limits, suggesting that the device is safe and effective. |
publishDate |
2013 |
dc.date.none.fl_str_mv |
2013-03-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-54492013000100005 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-54492013000100005 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/S1677-54492013000100005 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV) |
publisher.none.fl_str_mv |
Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV) |
dc.source.none.fl_str_mv |
Jornal Vascular Brasileiro v.12 n.1 2013 reponame:Jornal Vascular Brasileiro (Online) instname:Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV) instacron:SBACV |
instname_str |
Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV) |
instacron_str |
SBACV |
institution |
SBACV |
reponame_str |
Jornal Vascular Brasileiro (Online) |
collection |
Jornal Vascular Brasileiro (Online) |
repository.name.fl_str_mv |
Jornal Vascular Brasileiro (Online) - Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV) |
repository.mail.fl_str_mv |
||secretaria@sbacv.org.br |
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1752126646491545600 |