The usage of filterwire EZ TM embolic protection device during the percutan stent implantation for the aterosclerotic carotid artery stenosis

Between 2004 and 2005 we performed 32 carotid stent implantation with distal protection device FilterWire EZT in 32 consecutive patients. We used XactT stent in one patient, PreciseT stent in another and WallstentT in thirty patients. The filter system passed through the stenotic segment without predilatation in all patients. Only in four patients 3 mm balloon dilatation was needed before stenting. At the end of the procedure all the filters were closed and removed from the artery without any problem. Histopatological analysis were performed on the last seven filters with light microscopy after staining with hematoxylin-eosin at the Pathology department. In four of the seven filters, microscopically visible embolic material was captured. During the postprocedural hospital day and 30-day clinical follow up, no further neurological events (minor or major strokes) was observed in any patient. Only one patient with severe coronary problems before stenting suffered myocardial infaction and died 16 hours after carotid stent implantation. The patients were controlled with carotis Colour Doppler sonography on the first day, first, third, sixth months and first year of the procedure. In one patient we found 30% restenosis at the sixth month and 50% restenosis at first year follow up. According to improvements in carotid stenting equipment, and cerebrovascular protection devices, endovascular treatment became a serious alternative to endarterectomy in symptomatic patients with high surgical risk, and perhaps even in asymptomatic patients who are routine surgical candidates.