{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:13:11Z","timestamp":1792109591881,"version":"4.4.0"},"reference-count":44,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Interventions"],"published-print":{"date-parts":[[2013,10]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>Carotid artery stenting (CAS) has become an alternative treatment for patients presenting symptomatic carotid artery stenosis. The improvement in clinical outcomes with CAS has been associated with the development of embolic protection devices. The trial aim is to compare flow reversal versus filter protection during CAS through femoral access.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              Patients were randomly enrolled in CAS using flow reversal or filter protection. The primary end points were the incidence, number, and size of new ischemic brain lesions after CAS. The secondary end points included major adverse cardiac and cerebrovascular events, transient ischemic attack, and definitive ischemic brain lesions on fluid-attenuated inversion recovery magnetic resonance image at a 3-month follow-up. Ischemic brain lesions were assessed by a 3T magnetic resonance image. Neurological outcomes were evaluated by means of the National Institutes of Health Stroke Scale and the modified Rankin Scale (mRS). Forty consecutive patients were randomly assigned. Compared with flow reversal (n=21), filter protection (n=19) resulted in a significant reduction in the incidence (15.8% versus 47.6%,\n              <jats:italic>P<\/jats:italic>\n              =0.03), number (0.73 versus 2.6,\n              <jats:italic>P<\/jats:italic>\n              =0.05), and size (0.81 versus 2.23 mm,\n              <jats:italic>P<\/jats:italic>\n              =0.05) of new ischemic brain lesions. Two patients, 1 from each group, presented transient ischemic attack at 3-month follow-up. There were no major adverse cardiac and cerebrovascular events in the hospital or at 3-month follow-up.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>In this small sample size trial, filter protection was more effective than flow reversal in reducing ischemic brain lesions during CAS through femoral approach.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Clinical Trial Registration\u2014<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/portal2.saude.gov.br\/sisnep\/\">http:\/\/portal2.saude.gov.br\/sisnep\/<\/jats:ext-link>\n              . Unique identifier: 0538.0.004.000-10.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circinterventions.113.000479","type":"journal-article","created":{"date-parts":[[2013,10,2]],"date-time":"2013-10-02T05:08:25Z","timestamp":1380690505000},"page":"552-559","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":37,"title":["Flow Reversal Versus Filter Protection"],"prefix":"10.1161","volume":"6","author":[{"given":"Luis Henrique","family":"de Castro-Afonso","sequence":"first","affiliation":[{"name":"From the Division of Interventional Neuroradiology (L.H.d.C.-A., L.d.O., D.G.A.), Division of Neuroradiology (L.G.A., J.G.R., A.C.d.S.), and Division of Neurology (C.M.A.B., T.R.V., O.M.P.-N.), Medical School of Ribeir\u00e3o Preto, University of S\u00e3o Paulo, Ribeir\u00e3o Preto, SP, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas Giansante","family":"Abud","sequence":"additional","affiliation":[{"name":"From the Division of Interventional Neuroradiology (L.H.d.C.-A., L.d.O., D.G.A.), Division of Neuroradiology (L.G.A., J.G.R., A.C.d.S.), and Division of Neurology (C.M.A.B., T.R.V., O.M.P.-N.), Medical School of Ribeir\u00e3o Preto, University of S\u00e3o Paulo, Ribeir\u00e3o Preto, SP, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaicer Gon\u00e7alves","family":"Rolo","sequence":"additional","affiliation":[{"name":"From the Division of Interventional Neuroradiology (L.H.d.C.-A., L.d.O., D.G.A.), Division of Neuroradiology (L.G.A., J.G.R., A.C.d.S.), and Division of Neurology (C.M.A.B., T.R.V., O.M.P.-N.), Medical School of Ribeir\u00e3o Preto, University of S\u00e3o Paulo, Ribeir\u00e3o Preto, SP, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ant\u00f4nio Carlos","family":"dos Santos","sequence":"additional","affiliation":[{"name":"From the Division of Interventional Neuroradiology (L.H.d.C.-A., L.d.O., D.G.A.), Division of Neuroradiology (L.G.A., J.G.R., A.C.d.S.), and Division of Neurology (C.M.A.B., T.R.V., O.M.P.-N.), Medical School of Ribeir\u00e3o Preto, University of S\u00e3o Paulo, Ribeir\u00e3o Preto, SP, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L\u00edvia","family":"de Oliveira","sequence":"additional","affiliation":[{"name":"From the Division of Interventional Neuroradiology (L.H.d.C.-A., L.d.O., D.G.A.), Division of Neuroradiology (L.G.A., J.G.R., A.C.d.S.), and Division of Neurology (C.M.A.B., T.R.V., O.M.P.-N.), Medical School of Ribeir\u00e3o Preto, University of S\u00e3o Paulo, Ribeir\u00e3o Preto, SP, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara Monteiro Antunes","family":"Barreira","sequence":"additional","affiliation":[{"name":"From the Division of Interventional Neuroradiology (L.H.d.C.-A., L.d.O., D.G.A.), Division of Neuroradiology (L.G.A., J.G.R., A.C.d.S.), and Division of Neurology (C.M.A.B., T.R.V., O.M.P.-N.), Medical School of Ribeir\u00e3o Preto, University of S\u00e3o Paulo, Ribeir\u00e3o Preto, SP, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tonicarlo Rodrigues","family":"Velasco","sequence":"additional","affiliation":[{"name":"From the Division of Interventional Neuroradiology (L.H.d.C.-A., L.d.O., D.G.A.), Division of Neuroradiology (L.G.A., J.G.R., A.C.d.S.), and Division of Neurology (C.M.A.B., T.R.V., O.M.P.-N.), Medical School of Ribeir\u00e3o Preto, University of S\u00e3o Paulo, Ribeir\u00e3o Preto, SP, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oct\u00e1vio Marques","family":"Pontes-Neto","sequence":"additional","affiliation":[{"name":"From the Division of Interventional Neuroradiology (L.H.d.C.-A., L.d.O., D.G.A.), Division of Neuroradiology (L.G.A., J.G.R., A.C.d.S.), and Division of Neurology (C.M.A.B., T.R.V., O.M.P.-N.), Medical School of Ribeir\u00e3o Preto, University of S\u00e3o Paulo, Ribeir\u00e3o Preto, SP, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel Giansante","family":"Abud","sequence":"additional","affiliation":[{"name":"From the Division of Interventional Neuroradiology (L.H.d.C.-A., L.d.O., D.G.A.), Division of Neuroradiology (L.G.A., J.G.R., A.C.d.S.), and Division of Neurology (C.M.A.B., T.R.V., O.M.P.-N.), Medical School of Ribeir\u00e3o Preto, University of S\u00e3o Paulo, Ribeir\u00e3o Preto, SP, 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