{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T05:16:12Z","timestamp":1777526172593,"version":"3.51.4"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2011,7]]},"abstract":"<jats:sec>\n            <jats:title>Background and Purpose\u2014<\/jats:title>\n            <jats:p>To evaluate the periprocedural outcome after carotid artery stenting with embolic brain protection (EBP+) versus without embolic brain protection (EBP\u2212).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods\u2014<\/jats:title>\n            <jats:p>We retrospectively reviewed data from a prospective nonrandomized database of 357 patients who underwent carotid artery stenting in the neuroradiology division of our institution from 1999 to 2009. One hundred five patients underwent angioplasty and stenting without distal protection, whereas 252 were treated with distal protection. Patients were analyzed according to their EBP status (+ or \u2212) for the primary end points of perioperative stroke, death, or myocardial infarction.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results\u2014<\/jats:title>\n            <jats:p>\n              Unprotected stenting was mostly performed in the early years of this study and this is reflected in significant baseline differences between the two groups. In our earlier experience, carotid artery stenting was used in patients with more significant comorbidities. Diabetes mellitus (\n              <jats:italic>P<\/jats:italic>\n              =0.04), previous coronary artery disease (\n              <jats:italic>P<\/jats:italic>\n              =0.02) and myocardial infarction (\n              <jats:italic>P<\/jats:italic>\n              =0.04), and symptomatic lesion (\n              <jats:italic>P<\/jats:italic>\n              =0.01) were significantly more common in the EBP\u2212 cohort. Despite these baseline differences, there were no significant differences in the primary end points (2% in the EBP+ group and 4.8% in the EBP\u2212,\n              <jats:italic>P<\/jats:italic>\n              =0.15). The incidence of ipsilateral stroke in the EBP\u2212 and in the EBP+ group was 3.8% versus 0.8%, respectively (\n              <jats:italic>P<\/jats:italic>\n              =0.6). There were 2 perioperative deaths (1 in each group) and 4 myocardial infarctions (3 in the EBP+ arm and 1 in the EBP\u2212 arm, all non-Q infarcts;\n              <jats:italic>P<\/jats:italic>\n              =nonsignificant).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>In accordance with recent literature, this series cast doubts as to the real effectiveness of distal embolic protection devices in reducing periprocedural complications.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.110.607820","type":"journal-article","created":{"date-parts":[[2011,5,13]],"date-time":"2011-05-13T04:57:16Z","timestamp":1305262636000},"page":"1962-1966","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":36,"title":["Are Distal Protection Devices \u2018Protective\u2019 During Carotid Angioplasty and Stenting?"],"prefix":"10.1161","volume":"42","author":[{"given":"Tiziano","family":"Tallarita","sequence":"first","affiliation":[{"name":"From the Division of Vascular Surgery and the Departments of Neurology, Radiology, and Neurologic Surgery, Mayo Clinic, Rochester, MN."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alejandro A.","family":"Rabinstein","sequence":"additional","affiliation":[{"name":"From the Division of Vascular Surgery and the Departments of Neurology, Radiology, and Neurologic Surgery, Mayo Clinic, Rochester, MN."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harry","family":"Cloft","sequence":"additional","affiliation":[{"name":"From the Division of Vascular Surgery and the Departments of Neurology, Radiology, and Neurologic Surgery, Mayo Clinic, Rochester, MN."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Kallmes","sequence":"additional","affiliation":[{"name":"From the Division of Vascular Surgery and the Departments of Neurology, Radiology, and Neurologic Surgery, Mayo Clinic, Rochester, MN."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gustavo S.","family":"Oderich","sequence":"additional","affiliation":[{"name":"From the Division of Vascular Surgery and the Departments of Neurology, Radiology, and Neurologic Surgery, Mayo Clinic, Rochester, MN."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert D.","family":"Brown","sequence":"additional","affiliation":[{"name":"From the Division of Vascular Surgery and the Departments of Neurology, Radiology, and Neurologic Surgery, Mayo Clinic, Rochester, MN."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Lanzino","sequence":"additional","affiliation":[{"name":"From the Division of Vascular Surgery and the Departments of Neurology, Radiology, and Neurologic Surgery, Mayo Clinic, Rochester, MN."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa040127"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2010.03.003"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0912321"},{"key":"e_1_3_2_5_2","first-page":"1338","article-title":"Silent ischemia after neuroprotected percutaneous carotid stenting: a diffusion-weighted MRI study","volume":"27","author":"Pinero P","year":"2006","unstructured":"Pinero P, Gonzalez A, Mayol A, Martinez E, Gonzalez-Marcos JR, Boza F, Cayuela A, Gil-Peralta A. Silent ischemia after neuroprotected percutaneous carotid stenting: a diffusion-weighted MRI study. AJNR Am J Neuroradiol. 2006;27:1338\u20131345.","journal-title":"AJNR Am J Neuroradiol"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1159\/000275505"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2007.11.058"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.0000080938.80364.75"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)69122-8"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199108153250701"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A0879"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1583\/05-1573.1"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.0000185676.05358.f2"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A0871"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nec.2004.08.005"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.0000135763.62131.6a"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.108.514356"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(10)70057-0"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.21844"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.21359"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1067\/mva.2000.102730"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A1118"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.0000081000.23561.61"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.108.534289"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00234-010-0672-y"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2005.01.003"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2010.05.004"},{"key":"e_1_3_2_28_2","first-page":"584","article-title":"\u2018Is there a role for revascularisation in asymptomatic carotid stenosis? No.' BMJ head-to-head debate","volume":"341","author":"Spence JD","year":"2010","unstructured":"Spence JD. \u2018Is there a role for revascularisation in asymptomatic carotid stenosis? No.' BMJ head-to-head debate. 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