Embolic protection devices for carotid artery stenting: better results than stenting without protection?
Identifieur interne : 001C13 ( Istex/Corpus ); précédent : 001C12; suivant : 001C14Embolic protection devices for carotid artery stenting: better results than stenting without protection?
Auteurs : Ralf Zahn ; Bernd Mark ; Nikolaj Niedermaier ; Uwe Zeymer ; Peter Limbourg ; Thomas Ischinger ; Klaus Haerten ; Karl Eugen Hauptmann ; Enz-Ru Diger Von Leitner ; Wolfgang Kasper ; Ulrich Tebbe ; Jochen SengesSource :
- European Heart Journal [ 0195-668X ] ; 2004-09-01.
Abstract
Aims Carotid artery stenting (CAS) for carotid artery stenoses has become an alternative to carotid endarterectomy. However, CAS itself can cause cerebral ischaemic events. Embolic protection devices (PD) promise to reduce the incidence of these events. Methods and results From July 1996 to March 2003, 1483 patients from 26 hospitals were included in the prospective CAS Registry of the ALKK study group. A PD was used in 668 of 1483 patients (45%). The use of a PD has grown rapidly over the years and reached 100% in 2003. Patients treated with a PD had prior carotid artery dilatation more often (3.5% versus 1%, p<0.001), a prior myocardial infarction (34% versus 27.4%, p=0.007) and a history of arterial hypertension (89.9% versus 78.6%, p=0.007) compared to patients treated without a PD. A thrombus was more often visible in patients treated under distal protection (16.5% versus 8%, p<0.001). The use of a PD led to a 10-min longer intervention (45 min versus 35 min median, p<0.001). Patients treated with a PD had a lower rate of ipsilateral stroke (1.7% versus 4.1%, p=0.007) and a lower rate of all non-fatal strokes and all deaths (2.1% versus 4.9%, p=0.004) during the hospital stay. This was confirmed by multiple logistic regression analysis (adjusted OR=0.45, 95% CI: 0.23–0.91, p=0.026). A similar reduction could be found for symptomatic as well as asymptomatic carotid artery stenoses. Conclusion Since 1996 there has been a steady increase in the use of PDs for CAS, with a 100% use in 2003. The use of a PD may lower the rate of ipsilateral strokes during CAS.
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DOI: 10.1016/j.ehj.2004.06.018
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<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Embolic protection devices for carotid artery stenting: better results than stenting without protection?</title><author><name sortKey="Zahn, Ralf" sort="Zahn, Ralf" uniqKey="Zahn R" first="Ralf" last="Zahn">Ralf Zahn</name><affiliation><mods:affiliation>Herzzentrum, Kardiologie, Ludwigshafen, Germany</mods:affiliation></affiliation><affiliation><mods:affiliation>*Corresponding author. Tel.: +49-621-503-4000; fax: +49-621-503-4002 (</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: erzahn@aol.com).</mods:affiliation></affiliation></author><author><name sortKey="Mark, Bernd" sort="Mark, Bernd" uniqKey="Mark B" first="Bernd" last="Mark">Bernd Mark</name><affiliation><mods:affiliation>Herzzentrum, Kardiologie, Ludwigshafen, Germany</mods:affiliation></affiliation></author><author><name sortKey="Niedermaier, Nikolaj" sort="Niedermaier, Nikolaj" uniqKey="Niedermaier N" first="Nikolaj" last="Niedermaier">Nikolaj Niedermaier</name><affiliation><mods:affiliation>Städtisches Klinikum, Neurologie, Ludwigshafen, Germany</mods:affiliation></affiliation></author><author><name sortKey="Zeymer, Uwe" sort="Zeymer, Uwe" uniqKey="Zeymer U" first="Uwe" last="Zeymer">Uwe Zeymer</name><affiliation><mods:affiliation>Herzzentrum, Kardiologie, Ludwigshafen, Germany</mods:affiliation></affiliation></author><author><name sortKey="Limbourg, Peter" sort="Limbourg, Peter" uniqKey="Limbourg P" first="Peter" last="Limbourg">Peter Limbourg</name><affiliation><mods:affiliation>Stadtkrankenhaus, Kardiologie, Worms, Germany</mods:affiliation></affiliation></author><author><name sortKey="Ischinger, Thomas" sort="Ischinger, Thomas" uniqKey="Ischinger T" first="Thomas" last="Ischinger">Thomas Ischinger</name><affiliation><mods:affiliation>Städtisches Klinikum, Kardiologie, München-Bogenhausen, Germany</mods:affiliation></affiliation></author><author><name sortKey="Haerten, Klaus" sort="Haerten, Klaus" uniqKey="Haerten K" first="Klaus" last="Haerten">Klaus Haerten</name><affiliation><mods:affiliation>Marienkrankenhaus, Kardiologie, Wesel, Germany</mods:affiliation></affiliation></author><author><name sortKey="Hauptmann, Karl Eugen" sort="Hauptmann, Karl Eugen" uniqKey="Hauptmann K" first="Karl Eugen" last="Hauptmann">Karl Eugen Hauptmann</name><affiliation><mods:affiliation>Krankenhaus der Barmherzigen Brüder, Kardiologie, Trier, Germany</mods:affiliation></affiliation></author><author><name sortKey="Leitner, Enz Ru Diger Von" sort="Leitner, Enz Ru Diger Von" uniqKey="Leitner E" first="Enz-Ru Diger Von" last="Leitner">Enz-Ru Diger Von Leitner</name><affiliation><mods:affiliation>Klinikum Siloah, Kardiologie, Hannover, Germany</mods:affiliation></affiliation></author><author><name sortKey="Kasper, Wolfgang" sort="Kasper, Wolfgang" uniqKey="Kasper W" first="Wolfgang" last="Kasper">Wolfgang Kasper</name><affiliation><mods:affiliation>St. Josefs Hospital, Kardiologie, Wiesbaden, Germany</mods:affiliation></affiliation></author><author><name sortKey="Tebbe, Ulrich" sort="Tebbe, Ulrich" uniqKey="Tebbe U" first="Ulrich" last="Tebbe">Ulrich Tebbe</name><affiliation><mods:affiliation>Klinikum Lippe-Detmold, Kardiologie, Detmold, Germany</mods:affiliation></affiliation></author><author><name sortKey="Senges, Jochen" sort="Senges, Jochen" uniqKey="Senges J" first="Jochen" last="Senges">Jochen Senges</name><affiliation><mods:affiliation>Herzzentrum, Kardiologie, Ludwigshafen, Germany</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:1DC6C4C4BA06DCE56280DE18A06A1B5E61B82E68</idno><date when="2004" year="2004">2004</date><idno type="doi">10.1016/j.ehj.2004.06.018</idno><idno type="url">https://api.istex.fr/document/1DC6C4C4BA06DCE56280DE18A06A1B5E61B82E68/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">001C13</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">001C13</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Embolic protection devices for carotid artery stenting: better results than stenting without protection?</title><author><name sortKey="Zahn, Ralf" sort="Zahn, Ralf" uniqKey="Zahn R" first="Ralf" last="Zahn">Ralf Zahn</name><affiliation><mods:affiliation>Herzzentrum, Kardiologie, Ludwigshafen, Germany</mods:affiliation></affiliation><affiliation><mods:affiliation>*Corresponding author. Tel.: +49-621-503-4000; fax: +49-621-503-4002 (</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: erzahn@aol.com).</mods:affiliation></affiliation></author><author><name sortKey="Mark, Bernd" sort="Mark, Bernd" uniqKey="Mark B" first="Bernd" last="Mark">Bernd Mark</name><affiliation><mods:affiliation>Herzzentrum, Kardiologie, Ludwigshafen, Germany</mods:affiliation></affiliation></author><author><name sortKey="Niedermaier, Nikolaj" sort="Niedermaier, Nikolaj" uniqKey="Niedermaier N" first="Nikolaj" last="Niedermaier">Nikolaj Niedermaier</name><affiliation><mods:affiliation>Städtisches Klinikum, Neurologie, Ludwigshafen, Germany</mods:affiliation></affiliation></author><author><name sortKey="Zeymer, Uwe" sort="Zeymer, Uwe" uniqKey="Zeymer U" first="Uwe" last="Zeymer">Uwe Zeymer</name><affiliation><mods:affiliation>Herzzentrum, Kardiologie, Ludwigshafen, Germany</mods:affiliation></affiliation></author><author><name sortKey="Limbourg, Peter" sort="Limbourg, Peter" uniqKey="Limbourg P" first="Peter" last="Limbourg">Peter Limbourg</name><affiliation><mods:affiliation>Stadtkrankenhaus, Kardiologie, Worms, Germany</mods:affiliation></affiliation></author><author><name sortKey="Ischinger, Thomas" sort="Ischinger, Thomas" uniqKey="Ischinger T" first="Thomas" last="Ischinger">Thomas Ischinger</name><affiliation><mods:affiliation>Städtisches Klinikum, Kardiologie, München-Bogenhausen, Germany</mods:affiliation></affiliation></author><author><name sortKey="Haerten, Klaus" sort="Haerten, Klaus" uniqKey="Haerten K" first="Klaus" last="Haerten">Klaus Haerten</name><affiliation><mods:affiliation>Marienkrankenhaus, Kardiologie, Wesel, Germany</mods:affiliation></affiliation></author><author><name sortKey="Hauptmann, Karl Eugen" sort="Hauptmann, Karl Eugen" uniqKey="Hauptmann K" first="Karl Eugen" last="Hauptmann">Karl Eugen Hauptmann</name><affiliation><mods:affiliation>Krankenhaus der Barmherzigen Brüder, Kardiologie, Trier, Germany</mods:affiliation></affiliation></author><author><name sortKey="Leitner, Enz Ru Diger Von" sort="Leitner, Enz Ru Diger Von" uniqKey="Leitner E" first="Enz-Ru Diger Von" last="Leitner">Enz-Ru Diger Von Leitner</name><affiliation><mods:affiliation>Klinikum Siloah, Kardiologie, Hannover, Germany</mods:affiliation></affiliation></author><author><name sortKey="Kasper, Wolfgang" sort="Kasper, Wolfgang" uniqKey="Kasper W" first="Wolfgang" last="Kasper">Wolfgang Kasper</name><affiliation><mods:affiliation>St. Josefs Hospital, Kardiologie, Wiesbaden, Germany</mods:affiliation></affiliation></author><author><name sortKey="Tebbe, Ulrich" sort="Tebbe, Ulrich" uniqKey="Tebbe U" first="Ulrich" last="Tebbe">Ulrich Tebbe</name><affiliation><mods:affiliation>Klinikum Lippe-Detmold, Kardiologie, Detmold, Germany</mods:affiliation></affiliation></author><author><name sortKey="Senges, Jochen" sort="Senges, Jochen" uniqKey="Senges J" first="Jochen" last="Senges">Jochen Senges</name><affiliation><mods:affiliation>Herzzentrum, Kardiologie, Ludwigshafen, Germany</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">European Heart Journal</title><title level="j" type="abbrev">Eur Heart J</title><idno type="ISSN">0195-668X</idno><idno type="eISSN">1522-9645</idno><imprint><publisher>Oxford University Press</publisher><date type="published" when="2004-09-01">2004-09-01</date><biblScope unit="volume">25</biblScope><biblScope unit="issue">17</biblScope><biblScope unit="page" from="1550">1550</biblScope><biblScope unit="page" to="1558">1558</biblScope></imprint><idno type="ISSN">0195-668X</idno></series><idno type="istex">1DC6C4C4BA06DCE56280DE18A06A1B5E61B82E68</idno><idno type="DOI">10.1016/j.ehj.2004.06.018</idno><idno type="PII">S0195-668X(04)00418-X</idno><idno type="local">D128</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0195-668X</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Aims Carotid artery stenting (CAS) for carotid artery stenoses has become an alternative to carotid endarterectomy. However, CAS itself can cause cerebral ischaemic events. Embolic protection devices (PD) promise to reduce the incidence of these events. Methods and results From July 1996 to March 2003, 1483 patients from 26 hospitals were included in the prospective CAS Registry of the ALKK study group. A PD was used in 668 of 1483 patients (45%). The use of a PD has grown rapidly over the years and reached 100% in 2003. Patients treated with a PD had prior carotid artery dilatation more often (3.5% versus 1%, p<0.001), a prior myocardial infarction (34% versus 27.4%, p=0.007) and a history of arterial hypertension (89.9% versus 78.6%, p=0.007) compared to patients treated without a PD. A thrombus was more often visible in patients treated under distal protection (16.5% versus 8%, p<0.001). The use of a PD led to a 10-min longer intervention (45 min versus 35 min median, p<0.001). Patients treated with a PD had a lower rate of ipsilateral stroke (1.7% versus 4.1%, p=0.007) and a lower rate of all non-fatal strokes and all deaths (2.1% versus 4.9%, p=0.004) during the hospital stay. This was confirmed by multiple logistic regression analysis (adjusted OR=0.45, 95% CI: 0.23–0.91, p=0.026). A similar reduction could be found for symptomatic as well as asymptomatic carotid artery stenoses. Conclusion Since 1996 there has been a steady increase in the use of PDs for CAS, with a 100% use in 2003. The use of a PD may lower the rate of ipsilateral strokes during CAS.</div></front></TEI><istex><corpusName>oup</corpusName><author><json:item><name>Ralf Zahn</name><affiliations><json:string>Herzzentrum, Kardiologie, Ludwigshafen, Germany</json:string><json:string>*Corresponding author. Tel.: +49-621-503-4000; fax: +49-621-503-4002 (</json:string><json:string>E-mail: erzahn@aol.com).</json:string></affiliations></json:item><json:item><name>Bernd Mark</name><affiliations><json:string>Herzzentrum, Kardiologie, Ludwigshafen, Germany</json:string></affiliations></json:item><json:item><name>Nikolaj Niedermaier</name><affiliations><json:string>Städtisches Klinikum, Neurologie, Ludwigshafen, Germany</json:string></affiliations></json:item><json:item><name>Uwe Zeymer</name><affiliations><json:string>Herzzentrum, Kardiologie, Ludwigshafen, Germany</json:string></affiliations></json:item><json:item><name>Peter Limbourg</name><affiliations><json:string>Stadtkrankenhaus, Kardiologie, Worms, Germany</json:string></affiliations></json:item><json:item><name>Thomas Ischinger</name><affiliations><json:string>Städtisches Klinikum, Kardiologie, München-Bogenhausen, Germany</json:string></affiliations></json:item><json:item><name>Klaus Haerten</name><affiliations><json:string>Marienkrankenhaus, Kardiologie, Wesel, Germany</json:string></affiliations></json:item><json:item><name>Karl Eugen Hauptmann</name><affiliations><json:string>Krankenhaus der Barmherzigen Brüder, Kardiologie, Trier, Germany</json:string></affiliations></json:item><json:item><name>Enz-Rüdiger von Leitner</name><affiliations><json:string>Klinikum Siloah, Kardiologie, Hannover, Germany</json:string></affiliations></json:item><json:item><name>Wolfgang Kasper</name><affiliations><json:string>St. Josefs Hospital, Kardiologie, Wiesbaden, Germany</json:string></affiliations></json:item><json:item><name>Ulrich Tebbe</name><affiliations><json:string>Klinikum Lippe-Detmold, Kardiologie, Detmold, Germany</json:string></affiliations></json:item><json:item><name>Jochen Senges</name><affiliations><json:string>Herzzentrum, Kardiologie, Ludwigshafen, Germany</json:string></affiliations></json:item></author><language><json:string>eng</json:string></language><originalGenre><json:string>other</json:string></originalGenre><abstract>Aims Carotid artery stenting (CAS) for carotid artery stenoses has become an alternative to carotid endarterectomy. However, CAS itself can cause cerebral ischaemic events. Embolic protection devices (PD) promise to reduce the incidence of these events. Methods and results From July 1996 to March 2003, 1483 patients from 26 hospitals were included in the prospective CAS Registry of the ALKK study group. A PD was used in 668 of 1483 patients (45%). The use of a PD has grown rapidly over the years and reached 100% in 2003. Patients treated with a PD had prior carotid artery dilatation more often (3.5% versus 1%, p>0.001), a prior myocardial infarction (34% versus 27.4%, p=0.007) and a history of arterial hypertension (89.9% versus 78.6%, p=0.007) compared to patients treated without a PD. A thrombus was more often visible in patients treated under distal protection (16.5% versus 8%, p>0.001). The use of a PD led to a 10-min longer intervention (45 min versus 35 min median, p>0.001). Patients treated with a PD had a lower rate of ipsilateral stroke (1.7% versus 4.1%, p=0.007) and a lower rate of all non-fatal strokes and all deaths (2.1% versus 4.9%, p=0.004) during the hospital stay. This was confirmed by multiple logistic regression analysis (adjusted OR=0.45, 95% CI: 0.23–0.91, p=0.026). A similar reduction could be found for symptomatic as well as asymptomatic carotid artery stenoses. Conclusion Since 1996 there has been a steady increase in the use of PDs for CAS, with a 100% use in 2003. The use of a PD may lower the rate of ipsilateral strokes during CAS.</abstract><qualityIndicators><score>9.689</score><pdfVersion>1.3</pdfVersion><pdfPageSize>595 x 794 pts</pdfPageSize><refBibsNative>false</refBibsNative><keywordCount>0</keywordCount><abstractCharCount>1585</abstractCharCount><pdfWordCount>4689</pdfWordCount><pdfCharCount>31224</pdfCharCount><pdfPageCount>9</pdfPageCount><abstractWordCount>263</abstractWordCount></qualityIndicators><title>Embolic protection devices for carotid artery stenting: better results than stenting without protection?</title><pii><json:string>S0195-668X(04)00418-X</json:string></pii><refBibs><json:item><author></author><host><author></author><title>Stadtkrankenhaus Worms, Prof. Limbourg (234) Marienhospital Wesel, Prof. Haerten (151) Krankenhaus Barmherzige Brüder Trier St. Josefs Krankenhaus Wiesbaden</title></host></json:item><json:item><author><json:item><name> Kliniken Essen Nord</name></json:item><json:item><name> Dr</name></json:item><json:item><name> Jaksch</name></json:item></author><host><author></author><title>Städt. 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Editorial comment</title><publicationDate>2004</publicationDate></json:item><json:item><author><json:item><name>Gs Roubin</name></json:item><json:item><name>G New</name></json:item><json:item><name>Ss Iyer</name></json:item></author><host><volume>103</volume><pages><first>532</first></pages><author></author><title>Circulation</title><publicationDate>2001</publicationDate></host><title>Immediate and late clinical outcomes of carotid artery stenting in patients with symptomatic and asymptomatic carotid artery stenosis: a 5-year prospective analysis</title><publicationDate>2001</publicationDate></json:item><json:item><author><json:item><name>A Cremonesi</name></json:item><json:item><name>R Manetti</name></json:item><json:item><name>F Setacci</name></json:item></author><host><volume>34</volume><pages><last>41</last><first>1936</first></pages><author></author><title>Stroke</title><publicationDate>2003</publicationDate></host><title>Protected carotid stenting: clinical advantages and complications of embolic protection devices in 442 consecutive patients</title><publicationDate>2003</publicationDate></json:item></refBibs><genre><json:string>other</json:string></genre><host><volume>25</volume><publisherId><json:string>eurheartj</json:string></publisherId><pages><last>1558</last><first>1550</first></pages><issn><json:string>0195-668X</json:string></issn><issue>17</issue><genre><json:string>journal</json:string></genre><language><json:string>unknown</json:string></language><eissn><json:string>1522-9645</json:string></eissn><title>European Heart Journal</title></host><categories><wos><json:string>science</json:string><json:string>cardiac & cardiovascular systems</json:string></wos><scienceMetrix><json:string>health sciences</json:string><json:string>clinical medicine</json:string><json:string>cardiovascular system & hematology</json:string></scienceMetrix></categories><publicationDate>2004</publicationDate><copyrightDate>2004</copyrightDate><doi><json:string>10.1016/j.ehj.2004.06.018</json:string></doi><id>1DC6C4C4BA06DCE56280DE18A06A1B5E61B82E68</id><score>0.24666087</score><fulltext><json:item><extension>pdf</extension><original>true</original><mimetype>application/pdf</mimetype><uri>https://api.istex.fr/document/1DC6C4C4BA06DCE56280DE18A06A1B5E61B82E68/fulltext/pdf</uri></json:item><json:item><extension>zip</extension><original>false</original><mimetype>application/zip</mimetype><uri>https://api.istex.fr/document/1DC6C4C4BA06DCE56280DE18A06A1B5E61B82E68/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/1DC6C4C4BA06DCE56280DE18A06A1B5E61B82E68/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Embolic protection devices for carotid artery stenting: better results than stenting without protection?</title><respStmt><resp>Références bibliographiques récupérées via GROBID</resp><name resp="ISTEX-API">ISTEX-API (INIST-CNRS)</name></respStmt></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Oxford University Press</publisher><availability><p>The European Society of Cardiology</p></availability><date>2004</date></publicationStmt><notesStmt><note>Keywords Carotid arteries; Carotid artery stenting; Protection devices; Angioplasty</note><note>*Corresponding author. Tel.: +49-621-503-4000; fax: +49-621-503-4002 (E-mail: erzahn@aol.com).</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Embolic protection devices for carotid artery stenting: better results than stenting without protection?</title><author xml:id="author-1"><persName><forename type="first">Ralf</forename><surname>Zahn</surname></persName><email>erzahn@aol.com).</email><affiliation>Herzzentrum, Kardiologie, Ludwigshafen, Germany</affiliation><affiliation>*Corresponding author. Tel.: +49-621-503-4000; fax: +49-621-503-4002 (</affiliation></author><author xml:id="author-2"><persName><forename type="first">Bernd</forename><surname>Mark</surname></persName><affiliation>Herzzentrum, Kardiologie, Ludwigshafen, Germany</affiliation></author><author xml:id="author-3"><persName><forename type="first">Nikolaj</forename><surname>Niedermaier</surname></persName><affiliation>Städtisches Klinikum, Neurologie, Ludwigshafen, Germany</affiliation></author><author xml:id="author-4"><persName><forename type="first">Uwe</forename><surname>Zeymer</surname></persName><affiliation>Herzzentrum, Kardiologie, Ludwigshafen, Germany</affiliation></author><author xml:id="author-5"><persName><forename type="first">Peter</forename><surname>Limbourg</surname></persName><affiliation>Stadtkrankenhaus, Kardiologie, Worms, Germany</affiliation></author><author xml:id="author-6"><persName><forename type="first">Thomas</forename><surname>Ischinger</surname></persName><affiliation>Städtisches Klinikum, Kardiologie, München-Bogenhausen, Germany</affiliation></author><author xml:id="author-7"><persName><forename type="first">Klaus</forename><surname>Haerten</surname></persName><affiliation>Marienkrankenhaus, Kardiologie, Wesel, Germany</affiliation></author><author xml:id="author-8"><persName><forename type="first">Karl Eugen</forename><surname>Hauptmann</surname></persName><affiliation>Krankenhaus der Barmherzigen Brüder, Kardiologie, Trier, Germany</affiliation></author><author xml:id="author-9"><persName><forename type="first">Enz-Rüdiger von</forename><surname>Leitner</surname></persName><affiliation>Klinikum Siloah, Kardiologie, Hannover, Germany</affiliation></author><author xml:id="author-10"><persName><forename type="first">Wolfgang</forename><surname>Kasper</surname></persName><affiliation>St. Josefs Hospital, Kardiologie, Wiesbaden, Germany</affiliation></author><author xml:id="author-11"><persName><forename type="first">Ulrich</forename><surname>Tebbe</surname></persName><affiliation>Klinikum Lippe-Detmold, Kardiologie, Detmold, Germany</affiliation></author><author xml:id="author-12"><persName><forename type="first">Jochen</forename><surname>Senges</surname></persName><affiliation>Herzzentrum, Kardiologie, Ludwigshafen, Germany</affiliation></author></analytic><monogr><title level="j">European Heart Journal</title><title level="j" type="abbrev">Eur Heart J</title><idno type="pISSN">0195-668X</idno><idno type="eISSN">1522-9645</idno><imprint><publisher>Oxford University Press</publisher><date type="published" when="2004-09-01"></date><biblScope unit="volume">25</biblScope><biblScope unit="issue">17</biblScope><biblScope unit="page" from="1550">1550</biblScope><biblScope unit="page" to="1558">1558</biblScope></imprint></monogr><idno type="istex">1DC6C4C4BA06DCE56280DE18A06A1B5E61B82E68</idno><idno type="DOI">10.1016/j.ehj.2004.06.018</idno><idno type="PII">S0195-668X(04)00418-X</idno><idno type="local">D128</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2004</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Aims Carotid artery stenting (CAS) for carotid artery stenoses has become an alternative to carotid endarterectomy. However, CAS itself can cause cerebral ischaemic events. Embolic protection devices (PD) promise to reduce the incidence of these events. Methods and results From July 1996 to March 2003, 1483 patients from 26 hospitals were included in the prospective CAS Registry of the ALKK study group. A PD was used in 668 of 1483 patients (45%). The use of a PD has grown rapidly over the years and reached 100% in 2003. Patients treated with a PD had prior carotid artery dilatation more often (3.5% versus 1%, p<0.001), a prior myocardial infarction (34% versus 27.4%, p=0.007) and a history of arterial hypertension (89.9% versus 78.6%, p=0.007) compared to patients treated without a PD. A thrombus was more often visible in patients treated under distal protection (16.5% versus 8%, p<0.001). The use of a PD led to a 10-min longer intervention (45 min versus 35 min median, p<0.001). Patients treated with a PD had a lower rate of ipsilateral stroke (1.7% versus 4.1%, p=0.007) and a lower rate of all non-fatal strokes and all deaths (2.1% versus 4.9%, p=0.004) during the hospital stay. This was confirmed by multiple logistic regression analysis (adjusted OR=0.45, 95% CI: 0.23–0.91, p=0.026). A similar reduction could be found for symptomatic as well as asymptomatic carotid artery stenoses. Conclusion Since 1996 there has been a steady increase in the use of PDs for CAS, with a 100% use in 2003. The use of a PD may lower the rate of ipsilateral strokes during CAS.</p></abstract></profileDesc><revisionDesc><change when="2004-09-01">Published</change><change xml:id="refBibs-istex" who="#ISTEX-API" when="2016-12-22">References added</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/1DC6C4C4BA06DCE56280DE18A06A1B5E61B82E68/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus oup" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="US-ASCII"</istex:xmlDeclaration><istex:docType PUBLIC="-//NLM//DTD Journal Publishing DTD v2.3 20070202//EN" URI="journalpublishing.dtd" name="istex:docType"></istex:docType><istex:document><article xml:lang="en" article-type="other"><front><journal-meta><journal-id journal-id-type="hwp">ehj</journal-id><journal-id journal-id-type="nlm-ta">Eur Heart J</journal-id><journal-id journal-id-type="publisher-id">eurheartj</journal-id><journal-title>European Heart Journal</journal-title><abbrev-journal-title abbrev-type="publisher">Eur Heart J</abbrev-journal-title><issn pub-type="ppub">0195-668X</issn><issn pub-type="epub">1522-9645</issn><publisher><publisher-name>Oxford University Press</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="other">D128</article-id><article-id pub-id-type="doi">10.1016/j.ehj.2004.06.018</article-id><article-id pub-id-type="pii">S0195-668X(04)00418-X</article-id><article-categories><subj-group subj-group-type="heading"><subject>Clinical research</subject></subj-group></article-categories><title-group><article-title>Embolic protection devices for carotid artery stenting: better results than stenting without protection?</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Zahn</surname><given-names>Ralf</given-names></name><xref rid="AFF1"><sup>a</sup></xref><xref rid="COR1">*</xref></contrib><contrib contrib-type="author"><name><surname>Mark</surname><given-names>Bernd</given-names></name><xref rid="AFF1"><sup>a</sup></xref></contrib><contrib contrib-type="author"><name><surname>Niedermaier</surname><given-names>Nikolaj</given-names></name><xref rid="AFF2"><sup>b</sup></xref></contrib><contrib contrib-type="author"><name><surname>Zeymer</surname><given-names>Uwe</given-names></name><xref rid="AFF1"><sup>a</sup></xref></contrib><contrib contrib-type="author"><name><surname>Limbourg</surname><given-names>Peter</given-names></name><xref rid="AFF3"><sup>c</sup></xref></contrib><contrib contrib-type="author"><name><surname>Ischinger</surname><given-names>Thomas</given-names></name><xref rid="AFF4"><sup>d</sup></xref></contrib><contrib contrib-type="author"><name><surname>Haerten</surname><given-names>Klaus</given-names></name><xref rid="AFF5"><sup>e</sup></xref></contrib><contrib contrib-type="author"><name><surname>Hauptmann</surname><given-names>Karl Eugen</given-names></name><xref rid="AFF6"><sup>f</sup></xref></contrib><contrib contrib-type="author"><name><surname>Leitner</surname><given-names>Enz-Rüdiger von</given-names></name><xref rid="AFF7"><sup>g</sup></xref></contrib><contrib contrib-type="author"><name><surname>Kasper</surname><given-names>Wolfgang</given-names></name><xref rid="AFF8"><sup>h</sup></xref></contrib><contrib contrib-type="author"><name><surname>Tebbe</surname><given-names>Ulrich</given-names></name><xref rid="AFF9"><sup>i</sup></xref></contrib><contrib contrib-type="author"><name><surname>Senges</surname><given-names>Jochen</given-names></name><xref rid="AFF1"><sup>a</sup></xref></contrib><contrib contrib-type="group-author"><on-behalf-of>for the Arbeitsgemeinschaft Leitende Kardiologische Krankenhausärzte (ALKK)</on-behalf-of></contrib><aff id="AFF1"><label>a</label>Herzzentrum, Kardiologie, Ludwigshafen, Germany</aff><aff id="AFF2"><label>b</label>Städtisches Klinikum, Neurologie, Ludwigshafen, Germany</aff><aff id="AFF3"><label>c</label>Stadtkrankenhaus, Kardiologie, Worms, Germany</aff><aff id="AFF4"><label>d</label>Städtisches Klinikum, Kardiologie, München-Bogenhausen, Germany</aff><aff id="AFF5"><label>e</label>Marienkrankenhaus, Kardiologie, Wesel, Germany</aff><aff id="AFF6"><label>f</label>Krankenhaus der Barmherzigen Brüder, Kardiologie, Trier, Germany</aff><aff id="AFF7"><label>g</label>Klinikum Siloah, Kardiologie, Hannover, Germany</aff><aff id="AFF8"><label>h</label>St. Josefs Hospital, Kardiologie, Wiesbaden, Germany</aff><aff id="AFF9"><label>i</label>Klinikum Lippe-Detmold, Kardiologie, Detmold, Germany</aff></contrib-group><author-notes><corresp id="COR1"><label>*</label>Corresponding author. Tel.: +49-621-503-4000; fax: +49-621-503-4002 (E-mail: <ext-link xlink:href="erzahn@aol.com" ext-link-type="email">erzahn@aol.com</ext-link>).</corresp></author-notes><pub-date pub-type="ppub"><day>01</day><month>9</month><year>2004</year></pub-date><volume>25</volume><issue>17</issue><fpage>1550</fpage><lpage>1558</lpage><history><date date-type="accepted"><day>10</day><month>6</month><year>2004</year></date><date date-type="received"><day>6</day><month>3</month><year>2004</year></date><date date-type="rev-recd"><day>1</day><month>6</month><year>2004</year></date></history><permissions><copyright-statement>The European Society of Cardiology</copyright-statement><copyright-year>2004</copyright-year></permissions><abstract xml:lang="en"><sec><title>Aims</title><p>Carotid artery stenting (CAS) for carotid artery stenoses has become an alternative to carotid endarterectomy. However, CAS itself can cause cerebral ischaemic events. Embolic protection devices (PD) promise to reduce the incidence of these events.</p></sec><sec><title>Methods and results</title><p>From July 1996 to March 2003, 1483 patients from 26 hospitals were included in the prospective CAS Registry of the ALKK study group. A PD was used in 668 of 1483 patients (45%). The use of a PD has grown rapidly over the years and reached 100% in 2003. Patients treated with a PD had prior carotid artery dilatation more often (3.5% versus 1%, <italic>p</italic><0.001), a prior myocardial infarction (34% versus 27.4%, <italic>p</italic>=0.007) and a history of arterial hypertension (89.9% versus 78.6%, <italic>p</italic>=0.007) compared to patients treated without a PD. A thrombus was more often visible in patients treated under distal protection (16.5% versus 8%, <italic>p</italic><0.001). The use of a PD led to a 10-min longer intervention (45 min versus 35 min median, <italic>p</italic><0.001). Patients treated with a PD had a lower rate of ipsilateral stroke (1.7% versus 4.1%, <italic>p</italic>=0.007) and a lower rate of all non-fatal strokes and all deaths (2.1% versus 4.9%, <italic>p</italic>=0.004) during the hospital stay. This was confirmed by multiple logistic regression analysis (adjusted OR=0.45, 95% CI: 0.23–0.91, <italic>p</italic>=0.026). A similar reduction could be found for symptomatic as well as asymptomatic carotid artery stenoses.</p></sec><sec><title>Conclusion</title><p>Since 1996 there has been a steady increase in the use of PDs for CAS, with a 100% use in 2003. The use of a PD may lower the rate of ipsilateral strokes during CAS.</p></sec></abstract><custom-meta-wrap><custom-meta><meta-name>hwp-legacy-fpage</meta-name><meta-value>1550</meta-value></custom-meta><custom-meta><meta-name>hwp-legacy-dochead</meta-name><meta-value>Clinical research</meta-value></custom-meta></custom-meta-wrap></article-meta><notes><sec sec-type="arthw-remark"><title></title><p><italic>Keywords</italic> Carotid arteries; Carotid artery stenting; Protection devices; Angioplasty</p></sec></notes></front></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Embolic protection devices for carotid artery stenting: better results than stenting without protection?</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>Embolic protection devices for carotid artery stenting: better results than stenting without protection?</title></titleInfo><name type="personal"><namePart type="given">Ralf</namePart><namePart type="family">Zahn</namePart><affiliation>Herzzentrum, Kardiologie, Ludwigshafen, Germany</affiliation><affiliation>*Corresponding author. Tel.: +49-621-503-4000; fax: +49-621-503-4002 (</affiliation><affiliation>E-mail: erzahn@aol.com).</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Bernd</namePart><namePart type="family">Mark</namePart><affiliation>Herzzentrum, Kardiologie, Ludwigshafen, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Nikolaj</namePart><namePart type="family">Niedermaier</namePart><affiliation>Städtisches Klinikum, Neurologie, Ludwigshafen, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Uwe</namePart><namePart type="family">Zeymer</namePart><affiliation>Herzzentrum, Kardiologie, Ludwigshafen, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Peter</namePart><namePart type="family">Limbourg</namePart><affiliation>Stadtkrankenhaus, Kardiologie, Worms, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Thomas</namePart><namePart type="family">Ischinger</namePart><affiliation>Städtisches Klinikum, Kardiologie, München-Bogenhausen, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Klaus</namePart><namePart type="family">Haerten</namePart><affiliation>Marienkrankenhaus, Kardiologie, Wesel, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Karl Eugen</namePart><namePart type="family">Hauptmann</namePart><affiliation>Krankenhaus der Barmherzigen Brüder, Kardiologie, Trier, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Enz-Rüdiger von</namePart><namePart type="family">Leitner</namePart><affiliation>Klinikum Siloah, Kardiologie, Hannover, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Wolfgang</namePart><namePart type="family">Kasper</namePart><affiliation>St. Josefs Hospital, Kardiologie, Wiesbaden, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Ulrich</namePart><namePart type="family">Tebbe</namePart><affiliation>Klinikum Lippe-Detmold, Kardiologie, Detmold, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jochen</namePart><namePart type="family">Senges</namePart><affiliation>Herzzentrum, Kardiologie, Ludwigshafen, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="other" displayLabel="other"></genre><originInfo><publisher>Oxford University Press</publisher><dateIssued encoding="w3cdtf">2004-09-01</dateIssued><copyrightDate encoding="w3cdtf">2004</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract lang="en">Aims Carotid artery stenting (CAS) for carotid artery stenoses has become an alternative to carotid endarterectomy. However, CAS itself can cause cerebral ischaemic events. Embolic protection devices (PD) promise to reduce the incidence of these events. Methods and results From July 1996 to March 2003, 1483 patients from 26 hospitals were included in the prospective CAS Registry of the ALKK study group. A PD was used in 668 of 1483 patients (45%). The use of a PD has grown rapidly over the years and reached 100% in 2003. Patients treated with a PD had prior carotid artery dilatation more often (3.5% versus 1%, p<0.001), a prior myocardial infarction (34% versus 27.4%, p=0.007) and a history of arterial hypertension (89.9% versus 78.6%, p=0.007) compared to patients treated without a PD. A thrombus was more often visible in patients treated under distal protection (16.5% versus 8%, p<0.001). The use of a PD led to a 10-min longer intervention (45 min versus 35 min median, p<0.001). Patients treated with a PD had a lower rate of ipsilateral stroke (1.7% versus 4.1%, p=0.007) and a lower rate of all non-fatal strokes and all deaths (2.1% versus 4.9%, p=0.004) during the hospital stay. This was confirmed by multiple logistic regression analysis (adjusted OR=0.45, 95% CI: 0.23–0.91, p=0.026). A similar reduction could be found for symptomatic as well as asymptomatic carotid artery stenoses. Conclusion Since 1996 there has been a steady increase in the use of PDs for CAS, with a 100% use in 2003. The use of a PD may lower the rate of ipsilateral strokes during CAS.</abstract><note>Keywords Carotid arteries; Carotid artery stenting; Protection devices; Angioplasty</note><note type="author-notes">*Corresponding author. Tel.: +49-621-503-4000; fax: +49-621-503-4002 (E-mail: erzahn@aol.com).</note><relatedItem type="host"><titleInfo><title>European Heart Journal</title></titleInfo><titleInfo type="abbreviated"><title>Eur Heart J</title></titleInfo><genre type="journal">journal</genre><identifier type="ISSN">0195-668X</identifier><identifier type="eISSN">1522-9645</identifier><identifier type="PublisherID">eurheartj</identifier><identifier type="PublisherID-hwp">ehj</identifier><identifier type="PublisherID-nlm-ta">Eur Heart J</identifier><part><date>2004</date><detail type="volume"><caption>vol.</caption><number>25</number></detail><detail type="issue"><caption>no.</caption><number>17</number></detail><extent unit="pages"><start>1550</start><end>1558</end></extent></part></relatedItem><identifier type="istex">1DC6C4C4BA06DCE56280DE18A06A1B5E61B82E68</identifier><identifier type="DOI">10.1016/j.ehj.2004.06.018</identifier><identifier type="PII">S0195-668X(04)00418-X</identifier><identifier type="local">D128</identifier><accessCondition type="use and reproduction" contentType="copyright">The European Society of Cardiology</accessCondition><recordInfo><recordContentSource>OUP</recordContentSource></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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