{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T09:01:37Z","timestamp":1776848497903,"version":"3.51.2"},"reference-count":23,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2013,11,15]],"date-time":"2013-11-15T00:00:00Z","timestamp":1384473600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2014,3]]},"abstract":"<jats:sec><jats:title>Background &amp; Purpose<\/jats:title><jats:p>Embolic protection devices (EPD) may provide a mechanism to reduce peri\u2010procedural strokes. They are advocated by consensus guidelines and mandated for Medicare reimbursement. However, outcomes data remain mixed. We aimed to characterize the population of patients undergoing unprotected carotid artery stenting (CAS) and assess the utility of distal filter EPD (F\u2010EPD) in elective CAS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analyzed patients enrolled in the CARE Registry\u00ae undergoing CAS between May, 2005 and January, 2012. We assessed the relationship between distal F\u2010EPD use versus no use (No\u2010EPD) and the composite of in\u2010hospital death or stroke (MAE) in unadjusted and 1:3 propensity\u2010matched analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Embolic protection was not attempted in a total of 579 out of 13,263 cases performed (4.4%). Patients in the No\u2010EPD group had worse preprocedure neurologic risk factors including higher rates of acute evolving stroke, prior TIA\/stroke, symptomatic lesion status, spontaneous carotid artery dissection, and use of general anesthesia intraprocedurally (all Standardized Differences{sd} &gt;10). After exclusion of nonelective cases there was no significant difference in MAE between the No\u2010EPD and F\u2010EPD groups (1.6% vs. 2.3%, sd\u2009=\u20094.72). Additionally, after propensity matching, rates of MAE did not differ between the No\u2010EPD (<jats:italic>n<\/jats:italic>\u2009=\u2009355) and F\u2010EPD (<jats:italic>n<\/jats:italic>\u2009=\u20091065) groups (1.7% vs. 2.5%, sd\u2009=\u20095.87).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients selected to undergo unprotected CAS in contemporary practice have high rates of adverse preprocedure neurologic risk factors. Our propensity\u2010matched analysis did not demonstrate evidence of significant benefit or harm associated with use of F\u2010EPD in elective CAS patients. \u00a9 2013 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.25090","type":"journal-article","created":{"date-parts":[[2013,6,27]],"date-time":"2013-06-27T05:51:02Z","timestamp":1372312262000},"page":"595-602","source":"Crossref","is-referenced-by-count":10,"title":["Unprotected carotid artery stenting in modern practice"],"prefix":"10.1002","volume":"83","author":[{"given":"Jay","family":"Giri","sequence":"first","affiliation":[{"name":"Cardiovascular Medicine Division Hospital of the University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert W.","family":"Yeh","sequence":"additional","affiliation":[{"name":"Division of Cardiology Massachusetts General Hospital, Harvard Medical School Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin F.","family":"Kennedy","sequence":"additional","affiliation":[{"name":"St. Luke's Mid\u2010America Heart Institute University of Missouri \u2010 Kansas City Kansas City Missouri"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beau M.","family":"Hawkins","sequence":"additional","affiliation":[{"name":"Division of Cardiology Massachusetts General Hospital, Harvard Medical School Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ido","family":"Weinberg","sequence":"additional","affiliation":[{"name":"Division of Cardiology Massachusetts General Hospital, Harvard Medical School Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitchell D.","family":"Weinberg","sequence":"additional","affiliation":[{"name":"Division of Cardiology Massachusetts General Hospital, Harvard Medical School Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sahil A.","family":"Parikh","sequence":"additional","affiliation":[{"name":"University Hospitals Harrington Heart and Vascular Institute and Case Western Reserve University School of Medicine Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Garasic","sequence":"additional","affiliation":[{"name":"Division of Cardiology Massachusetts General Hospital, Harvard Medical School Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael R.","family":"Jaff","sequence":"additional","affiliation":[{"name":"Division of Cardiology Massachusetts General Hospital, Harvard Medical School Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher J.","family":"White","sequence":"additional","affiliation":[{"name":"John Ochsner Heart and Vascular Institute Ochsner Medical Center New Orleans Louisiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth","family":"Rosenfield","sequence":"additional","affiliation":[{"name":"Division of Cardiology Massachusetts General Hospital, Harvard Medical School Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,11,15]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000058160.53040.5F"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.10645"},{"key":"e_1_2_7_4_1","first-page":"47;760","article-title":"A randomized trial of carotid artery stenting with and without cerebral protection","author":"Barbato JE","year":"2008","journal-title":"J Vasc 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