Proximal Endovascular Occlusion Found Safe for Stenting

Using PEO for carotid artery stenting results in 99.7 percent success rate, few adverse events

THURSDAY, April 15 (HealthDay News) -- Proximal endovascular occlusion (PEO) can be safely and effectively used during the placement of a carotid artery stent, according to a study in the April 20 issue of the Journal of the American College of Cardiology.

Eugenio Stabile, M.D., of Clinica Montevergine in Mercogliano, Italy, and colleagues studied a group of 1,300 patients who had carotid artery stenting (CAS) with accompanying PEO from July 2004 to May 2009. The subjects underwent neurological assessment before the procedure and at one-hour, 24-hour, and 30-day follow-up.

The researchers note that the procedure was successful in 99.7 percent of patients. Among the major adverse events in the hospital were five deaths (0.38 percent), six major strokes (0.46 percent) and five minor strokes (0.38 percent). By 30-day follow-up, two additional patients had died (0.15 percent), and 1 patient had a minor stroke (0.07 percent). Overall, the 30-day stroke and death incidence was 1.38 percent, with symptomatic patients exhibiting a higher stroke and death incidence than asymptomatic patients (3.04 compared to 0.82 percent). There was no significant difference in 30-day stroke and death rates between patients judged to be at high and average surgical risk. The predictors of adverse events included operator experience, symptomatic status, and hypertension.

"The use of PEO for CAS is safe and effective in an unselected patient population. Anatomical and/or clinical conditions of high surgical risk were not associated with an increased rate of adverse events," the authors write.

One study author reported being a consultant for Invatec (Italy), and proctoring for Mo.Ma Systems. The Mo.Ma system, made by Invatec, was used in the study.

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