Paladin: New Carotid Protection System with Good Results

Courtesy of Dr. Carlos Fava.

Carotid artery stenting (CAS) with a cerebral protection system has emerged as an alternative to surgery, particularly for patients with high surgical risk.

Es un hecho: la protección cerebral en TAVI logró demostrar que reduce el stroke y la muerteNowadays, there are a considerable number of cerebral protection systems, but these may sometimes fail due to anatomical issues, the diameter of embolized particles, or placement difficulties (among other reasons).

 

Proximal and distal protection systems have been developed, and they seem to offer additional benefits compared with traditional filters.

 

This study analyzed 106 patients who underwent CAS with the Paladin protection system, composed of a semi-compliant balloon and a nitinol filter protecting arteries up to 7 mm through a membrane with 40-µm pores.


Read also: ACC 2019 | STOPDAPT-2: P2Y12 Monotherapy After Short-Term Dual Antiplatelet Therapy After Angioplasty.


Patient age was 70 years; most patients were male; 19.3% had diabetes, 36.3% had symptoms, 11.3% had prior acute myocardial infarction, 9.4% had prior myocardial revasculatization surgery, 15.1% had prior endarterectomy, and 5.7% had received neck radiation. Right CAS was more frequent.

 

Distal embolic protection was successful in 105 patients and there were no in-hospital events. At 30 days, only one patient experienced a stroke (probably unrelated to the procedure); there were no deaths or infarctions.

 

Magnetic resonance imaging showed new ischemic lesions in 11 patients and new ipsilateral lesions in another 9 patients. Lesion volume per patient was 0.01 cm3.


Read also: ACC 2019 | SMART-CHOICE: Aspirin Increasingly “Against the Ropes”.


Researchers analyzed 46 filters; debris was present in all of them. About 90% of all captured particles were smaller than 100 μm.

 

Conclusion

Use of the Paladin protection system during carotid artery stenting seems to be safe and, perhaps, very effective as regards the reduction of the number of embolic particles reaching the brain. Consequently, it may reduce the rates of procedure-related stroke.

 

Courtesy of Dr. Carlos Fava.

 

Original title: Double Filtration During Carotid Artery Stenting Using a Novel Post-Dilation Balloon with Integrated Embolic Protection.

Reference: Ralf Langhoff et al. J Am Coll Cardiol Intv 2019;12:395-403


Subscribe to our weekly newsletter

Get the latest scientific articles on interventional cardiology

We are interested in your opinion. Please, leave your comments, thoughts, questions, etc., below. They will be most welcome.

More articles by this author

TCT 2024 | SIRONA: Randomized Study Comparing Sirolimus-Coated vs Paclitaxel-Coated Balloon Angioplasty in Femoropopliteal Disease

This prospective, randomized, multicenter, investigator-initiated non-inferiority study compared the use of sirolimus-coated balloon (MagicTouch) vs paclitaxel-coated balloon in endovascular treatment.  The primary objective was to...

TCT 2024 | PEERLESS: Mechanical Thrombectomy with FlowTriever vs Catheter-Directed Thrombolysis in Intermediate Risk PTE

Pulmonary embolism (PE) continues to be the third cause of cardiovascular mortality. The current clinical guidelines recommend anticoagulation in intermediate risk patients presenting right...

Atherosclerotic Renal Artery Stenosis: To Revascularize or Not

At long term, atherosclerotic renal artery stenosis (RAS) can lead to hypertension, chronic kidney disease, and cardiac failure. Historically, these patients have been referred...

Endovascular Management of Chronic TEPH: Is Coronary Management Extrapolatable in This Scenario?

Chronic thromboembolic pulmonary hypertension (CTEPH) is a condition that causes significant functional limitation. Its surgical treatment, known as pulmonary endarterectomy (PEA), has improved the...

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Related Articles

SOLACI Sessionsspot_img

Recent Articles

TCT 2024 | FAVOR III EUROPA

The study FAVOR III EUROPA, a randomized trial, included 2,000 patients with chronic coronary syndrome, or stabilized acute coronary syndrome, and intermediate lesions. 1,008...

TCT 2024 | TRISCEND II

This randomized study included 400 patients; 267 were treated with EVOQUE valve and 133 with optimal medical treatment (OMT). After one-year follow-up, there were no...

TCT 2024 – ACCESS-TAVI: Comparing Percutaneous Access Closure Strategies After TAVI

Vascular access complications following transcatheter aortic valve implantation (TAVI) remain common. However, few studies compare vascular access closure methods.  Based on the CHOICE-CLOSURE and MASH...