Vol. 23 No. 2 (2019)
CASE REPORTS

The combined use of proximal and distal protection devices uring carotid stenting: A case report

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  • D. Malaev,
  • D. Redkin,
  • V. Baystrukov,
  • A. Prokhorikhin,
  • A. Boykov,
  • E. Kretov
D. Malaev
Meshalkin National Medical Research Center, Novosibirsk, Russian Federation
Bio
D. Redkin
Meshalkin National Medical Research Center, Novosibirsk, Russian Federation
V. Baystrukov
Meshalkin National Medical Research Center, Novosibirsk, Russian Federation
A. Prokhorikhin
Meshalkin National Medical Research Center, Novosibirsk, Russian Federation
A. Boykov
Meshalkin National Medical Research Center, Novosibirsk, Russian Federation
E. Kretov
Meshalkin National Medical Research Center, Novosibirsk, Russian Federation
DOI: https://doi.org/10.21688/1681-3472-2019-2-73-79

Published 2019-10-15

Keywords

  • carotid artery stenting,
  • distal protection device,
  • embolic complications,
  • perioperative stroke,
  • proximal protection device

How to Cite

Malaev, D., Redkin, D., Baystrukov, V., Prokhorikhin, A., Boykov, A., & Kretov, E. (2019). The combined use of proximal and distal protection devices uring carotid stenting: A case report. Patologiya Krovoobrashcheniya I Kardiokhirurgiya, 23(2), 73–79. https://doi.org/10.21688/1681-3472-2019-2-73-79

Copyright (c) 2019 Malaev D. U., Redkin D. A., Baystrukov V. I., Prokhorikhin A. A., Boykov A. A., Kretov E. I.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Abstract

Despite the development of modern medical technologies, cerebrovascular disease remains a major health and social issue. Among all the cases of ischemic stroke, approximately 20% are attributable to stenotic lesions in the carotid artery. The main drawback of carotid stenting is the risk of embolic complications during the procedure. To resolve this problem, various devices that protect against embolism have been developed. In this clinical case, we describe the ability to minimize the risk of operative stroke through a combined application of the distal and proximal protection systems in carotid stenting.

In our patient, a 65-year-old woman, angiography of the carotid arteries revealed an ulcerated atherosclerotic plaque of the right internal carotid artery, with stenosis of the lumen of up to 95%. Considering the high risk of distal embolism, the Mo MaUltra (Italy) proximal protection system was used. When evaluating the installation of the Mo MaUltra system, the preserved blood flow through the superior thyroid artery and, therefore, the antegrade blood flow in the internal carotid artery was revealed. Considering the identified risk and the anatomy of the plaque surface, we decided on the additional use of the distal SpiderFX (USA) protection device.

The combined use of proximal protection system and distal protective device for carotid stenting is technically possible and may reduce the risk of embolic complications.

Received 23 January 2019. Revised 18 March 2019. Published 23 April 2019.

Informed consent: The patient’s informed consent to use the records for medical purposes is obtained.

Funding: The study did not have sponsorship.

Conflict of interest: Authors declare no conflict of interest.

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