Treatment results of carotid artery stenting under distal protection with the use of Angioguard XP compared with those of PercuSurge GuardWire

Objective: To compare clinical results of carotid artery stenting (CAS) under distal protection with the use of Angioguard XP and PercuSurge GuardWire. Methods: 138 patients treated by CAS under distal protection from September 2002 to November 2008 were included in this study. 85 patients treated with GuardWire were divided into 2 sequential groups, the early GW group (n=42) and the late GW group (n=43). Angioguard XP was used in 53 patients (the AG group) from November 2007. Treatment results from the 3 groups were investigated. Results: A stent was successfully deployed in all patients. 1 patient in the early GW group died of intracerebral hemorrhage which developed 5 days after CAS. In the late GW group, 1 patient died of multiple organ failure after intraoperative abdominal wall hemorrhage and another patient showed persistent hemiparesis due to intracerebral hemorrhage which occurred 1 week after CAS. Procedure-associated learning curve was not demonstrated between the 2 groups. In the AG group, postoperative MRI diffusion-weighted imaging disclosed new high-intensity lesions in the area of the treated carotid artery in 7 patients, in which 2 patients suffered from thromboembolic strokes. Conclusion: Hemorrhagic complications were causes of disability for patients treated with GuardWire. Thromboembolic events were more frequently encountered in patients undergoing CAS with Angioguard XP.