to minimize the risk of embolic events, several protection strategies have been introduced. we have evaluated the short-term outcome of patients who underwent carotid stenting with the routine use of cerebral protection devices. in our center, 36 successful carotid stenting procedures (of 38 attempted) were performed in 37 patients (23 men; age mean [sd] 667 years). cerebral protection involv...

For brain metabolism, energy is derived from circulatory provision of oxygen and glucose. Surgery, anaesthesia, peri-operative stresses or other etiological factors can lead to decrease in oxygen supply leading to ischemia, with consequent interruption of metabolic process. This Ischemia stimulates active responses in the brain, which may persist long after substrate delivery has been restored....

Brain perfusion for adequate cerebral protection has changed over the years. The limitations of the time during total circulatory arrest with deep hypotermia, the inefficient cerebral metabolism during retrograde perfusion and special care to prevent cerebral embolism during antegrade perfusion have resulted in the development of different methods of cerebral protection during the evolution of ...

BACKGROUND The use of a distal filter cerebral protection device with carotid artery stenting is commonplace. There is little evidence, however, that filters are effective in preventing embolic lesions. This study examined the incidence of embolic phenomenon during carotid artery stenting with and without filter use. METHODS This was a prospective, randomized, single-center study of carotid a...

(1) Cerebral protection devices offer a new approach to reducing the risk of stroke and death in patients undergoing carotid angioplasty with stenting (CAS). (2) Nine studies have examined the efficacy of cerebral protection devices, by comparing the incidence of procedure related stroke and death to that of CAS without protection, and to surgical endarterectomy. Few of the studies were of high...

The initial concept of brain protection during neurosurgery is based on research done in the 1970s-1980 which established the concept that by decreasing cerebral metabolic rate the brain could survive longer periods of ischemia. The first section of this chapter reviews some of this initial research that promoted the use of barbiturates for cerebral protection. The second section reviews curren...

BACKGROUND Carotid angioplasty and stenting (CAS) is increasingly being used for treatment of symptomatic and asymptomatic carotid artery disease (CAD). To evaluate the efficacy of cerebral protection devices in preventing thromboembolic complications during CAS, we conducted a systematic review of studies reporting on the incidence of minor stroke, major stroke, or death within 30 days after C...