{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T16:11:30Z","timestamp":1785859890370,"version":"3.56.0"},"reference-count":45,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2016,11,12]],"date-time":"2016-11-12T00:00:00Z","timestamp":1478908800000},"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":[[2017,4]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Carotid artery stenting (CAS) is typically performed using embolic protection devices (EPDs) as a means to reduce the risk of procedure\u2010related stroke. In this study, we compared procedural morbidity and mortality associated with distal (D\u2010EPD) vs. proximal (P\u2010EPD) protection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were queried from January 1998 through May 2015. Only studies comparing (D\u2010EPD) and (P\u2010EPD) were included. Two independent reviewers selected and appraised studies and extracted data in duplicate. Random\u2010effects meta\u2010analysis was used to pool outcomes across studies. Heterogeneity of treatment effect among studies was assessed using the <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> statistics. Publication bias was assessed using inspection of funnel plots. The primary endpoints included 30\u2010day mortality and stroke. Secondary endpoints included new cerebral lesions on diffusion\u2010weighted magnetic resonance imaging (DW\u2010MRI) and contralateral lesions on DW\u2010MRI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 12,281 patients were included from 18 studies (13 prospective and 5 retrospective) comparing (D\u2010EPD) and (P\u2010EPD) in the setting of CAS. The mean patient age was 69 years and 64% of patients were male. No evidence of publication bias was detected. There was no significant difference between the two modalities in terms of the risk of stroke (risk difference [RD] 0.0, 95% confidence interval [CI] \u22120.01 to 0.01) or mortality (RD 0.0, 95% CI \u22120.01 to 0.01) nor was there any difference in the incidence of new cerebral lesions on DW\u2010MRI or contralateral DW\u2010MRI lesions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In patients undergoing CAS, both D\u2010EPD and P\u2010EPD provide similar levels of protection from peri\u2010procedural stroke and 30 days mortality. \u00a9 2016 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.26842","type":"journal-article","created":{"date-parts":[[2016,11,16]],"date-time":"2016-11-16T16:03:37Z","timestamp":1479312217000},"page":"923-931","source":"Crossref","is-referenced-by-count":24,"title":["Proximal balloon occlusion versus distal filter protection in carotid artery stenting: A meta\u2010analysis and review of the literature"],"prefix":"10.1002","volume":"89","author":[{"given":"Jad","family":"Omran","sequence":"first","affiliation":[{"name":"Cardiovascular Medicine Department University of Missouri\u2010Columbia School of Medicine Columbia Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ehtisham","family":"Mahmud","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine Sulpizio Cardiovascular Center, University of California San Diego, La Jolla California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher J.","family":"White","sequence":"additional","affiliation":[{"name":"Department of Cardiology Ochsner Clinic Foundation New Orleans Louisiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herbert D.","family":"Aronow","sequence":"additional","affiliation":[{"name":"Lifespan Cardiovascular Institute, Warren Alpert Medical School of Brown University Providence Rhode Island"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas E.","family":"Drachman","sequence":"additional","affiliation":[{"name":"Department of Cardiology Massachusetts General Hospital Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Gray","sequence":"additional","affiliation":[{"name":"Lankenau Heart Institute Wynnewood Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Obai","family":"Abdullah","sequence":"additional","affiliation":[{"name":"Cardiovascular Medicine Department University of Missouri\u2010Columbia School of Medicine Columbia Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mazen","family":"Abu\u2010Fadel","sequence":"additional","affiliation":[{"name":"Section of Cardiovascular Disease University of Oklahoma Health Sciences Center Oklahoma City Oklahoma"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Belal","family":"Firwana","sequence":"additional","affiliation":[{"name":"Hematology and Oncology University of Arkansas for Medical Sciences Little Rock AR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gergory","family":"Mishkel","sequence":"additional","affiliation":[{"name":"Prairie Cardiovascular Consultants Springfield Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashraf S.","family":"Al\u2010Dadah","sequence":"additional","affiliation":[{"name":"Prairie Cardiovascular Consultants Springfield Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,11,12]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.110.610212"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60239-5"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa040127"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2009.05.010"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2014.05.019"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehr211"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e31820d8d78"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2012.05.077"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.11.079"},{"key":"e_1_2_6_11_1","unstructured":"Schu\u00fcnemannHJ OxmanAD HigginsJPT VistGE GlasziouP GuyattGH. 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