{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T17:41:42Z","timestamp":1780076502442,"version":"3.54.0"},"reference-count":32,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2016,7,9]],"date-time":"2016-07-09T00:00:00Z","timestamp":1468022400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Endovasc Ther"],"published-print":{"date-parts":[[2016,8]]},"abstract":"<jats:p>Purpose: To compare the feasibility and safety of proximal cerebral protection to a distal filter during carotid artery stenting (CAS) via a transbrachial (TB) or transradial (TR) approach. Methods: Among 856 patients who underwent CAS between January 2007 and July 2015, 214 (25%) patients (mean age 72\u00b18 years; 154 men) had the procedure via a TR (n=154) or TB (n=60) approach with either Mo.MA proximal protection (n=61) or distal filter protection (n=153). The Mo.MA group (mean age 73\u00b17 years; 54 men) had significantly more men and more severe stenosis than the filter group (mean age 71\u00b18 years; 100 men). Stent type and CAS technique were left to operator discretion. Heparin and a dedicated closure device or bivalirudin and manual compression were used in TR and TB accesses, respectively. Technical and procedure success, crossover to femoral artery, 30-day major adverse cardiovascular\/cerebrovascular events (MACCE; death, all strokes, and myocardial infarction), vascular complications, and radiation exposure were compared between groups. Results: Crossover to a femoral approach was required in 1\/61 (1.6%) Mo.MA patient vs 11\/153 (7.1%) filter patients mainly due to technical difficulty in engaging the target vessel. Five Mo.MA patients developed acute intolerance to proximal occlusion; 4 were successfully shifted to filter protection. A TR patient was shifted to filter because the Mo.MA system was too short. CAS was technically successful in the remaining 55 (90%) Mo.MA patients and 142 (93%) filter patients. The MACCE rate was 0% in the Mo.MA patients and 2.8% in the filter group (p=0.18). Radiation exposure was similar between groups. Major vascular complications occurred in 1\/61 (1.6%) and in 3\/153 (1.96%) patients in the Mo.MA and filter groups (p=0.18), respectively, and were confined to the TB approach in the early part of the learning curve. Chronic radial artery occlusion was detected by Doppler ultrasound in 2\/30 (6.6%) Mo.MA patients and in 4\/124 (3.2%) filter patients by clinical assessment (p=0.25) at 8.1\u00b17.5-month follow-up. Conclusion: CAS with proximal protection via a TR or TB approach is a feasible, safe, and effective technique with a low rate of vascular complications.<\/jats:p>","DOI":"10.1177\/1526602816651424","type":"journal-article","created":{"date-parts":[[2016,6,6]],"date-time":"2016-06-06T21:53:59Z","timestamp":1465250039000},"page":"549-560","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":44,"title":["Carotid Artery Stenting With Proximal Embolic Protection via a Transradial or Transbrachial Approach"],"prefix":"10.1177","volume":"23","author":[{"given":"Piero","family":"Montorsi","sequence":"first","affiliation":[{"name":"Department of Clinical Sciences and Community Health, University of Milan, Italy"},{"name":"Centro Cardiologico Monzino, IRCCS, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Galli","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences and Community Health, University of Milan, Italy"},{"name":"Centro Cardiologico Monzino, IRCCS, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo M.","family":"Ravagnani","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences and Community Health, University of Milan, Italy"},{"name":"Centro Cardiologico Monzino, IRCCS, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Tresoldi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Ospedale di Desio, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Teruzzi","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences and Community Health, University of Milan, Italy"},{"name":"Centro Cardiologico Monzino, IRCCS, Milan, 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