Feature | January 23, 2014

Study Finds No Significant Differences Between Commonly Used Carotid Stenting Systems in U.S.

Rates of death and stroke similarly low for three major systems

Carotid Stent Clinical Study Abbott Cordis National Cardiovascular Data Registry

Abbott Acculink Carotid Stent

January 23, 2014 — The three most common systems to place stents in blocked carotid arteries of the neck have similarly low rates of complication and death among U.S. patients, according to a study published by JACC: Cardiovascular Interventions.
 
“We found low rates of in-hospital death and stroke with carotid stenting regardless of the devices used on the order of 2 percent,” said lead author Jay Giri, M.D., M.P.H., assistant professor of clinical medicine at the University of Pennsylvania. “A tremendous amount of time and energy has been spent theorizing about various technical considerations of carotid stenting systems that might make one superior to another. Our study effectively argues that continued focus on these specific technical aspects is unlikely to significantly improve stroke and death rates around carotid stenting. The bottom line is that our finding should provide support for operators to use their judgment to select the stent most favorable for a particular anatomic or clinical situation.”
 
The study analyzed 12,135 consecutive carotid stent procedures in the National Cardiovascular Data Registry performed between January 2007 and March 2012. Penn researchers compared rates of in-hospital combined death/stroke among patients treated with Acculink/Accunet (Abbott), Xact/Emboshield (Abbott) and Precise/Angioguard (Cordis) stent/embolic protection device (EPD) combinations. The study found that in nearly 80 percent of cases examined, physicians paired stents with the corresponding EPD produced by the stent manufacturer. 
 
“In other types of non-carotid stenting, doctors often mix and match products from different companies,” Giri said. “With carotids, by and large, they don’t. They use companion stents and embolic protection devices from one company.”
 
Factors that may influence this pattern of use include that the U.S. Food and Drug Administration (FDA) approves carotid stenting systems as a unit of stent and EPD; operators may be more comfortable using an FDA-approved unit rather than “mixing and matching” stents with other EPDs; and reimbursement restrictions from Centers for Medicare & Medicaid Services (CMS).
 
The National Cardiovascular Data Registry supported this research by funding for statistical support.
 
For more information: www.upenn.edu

Related Content

DEFUSE-2 study, MRI, brain bleeding risk, post-stroke treatment, NIH

This image combines pre- and post-treatment scans from the same patient. Analysis of the two scans revealed that the area and size of post-treatment bleeding corresponded to blood-brain barrier disruption (shown in green, yellow and red) prior to therapy. Image courtesy of Richard Leigh, NINDS.

News | Stroke| June 29, 2016
In a study of stroke patients, investigators confirmed through magnetic resonance imaging (MRI) brain scans an...
U.K., NHS studies, weekend effect, hospital admission, atrial fibrillation, heart failure
News | Clinical Study| June 28, 2016
New research shows patients admitted to National Health Service (NHS) hospitals in the United Kingdom for atrial...
CT scans, cancer risk, radiation dose, Canadian study
News | Computed Tomography (CT)| June 27, 2016
June 27, 2016 — A new study in the Journal of Medical Imaging and Radiation Sciences surveyed doctors, radiologists a
News | Cardiac Diagnostics| June 24, 2016
Measuring antibody levels in the blood could be used to detect a person’s heart attack risk after researchers, part-...
Zoll LifeVest wearable defibrillator, WEARIT-II Registry results, CardioStim EuroPace 2016
News | Defibrillator Monitors| June 21, 2016
Zoll Medical Corp. announced that patients experience a high one-year survival rate following use of the LifeVest...
News | Implantable Cardioverter Defibrillators (ICD)| June 14, 2016
Medtronic plc announced results from several feasibility studies evaluating a new approach to implantable cardioverter...
hypertrophic cardiomyopathy, HCM, strain echocardiography, risk assessment, ASE 2016
News | Cardiovascular Ultrasound| June 13, 2016
After following a large sub-set of patients, researchers found that by using strain echocardiography they could...
ASE 2016, Mayo Clinic study, echocardiography, aortic flow rate, patient risk stratification
News | Cardiovascular Ultrasound| June 13, 2016
Researchers from Mayo Clinic believe they have found a better way to risk stratify some of their most fragile patients.
hemmorhagic stroke, blood pressure management, ATACH II trial, NINDS

Brain scan showing damage caused by bleeding during a hemorrhagic stroke. Image courtesy of Adnan I Qureshi, M.D., University of Minnesota.

News | Stroke| June 09, 2016
June 9, 2016 — An international stroke study
Medtronic, Micra TPS pacemaker, Global Clinical Trial, Cardiostim 2016
News | Pacemakers| June 09, 2016
Medtronic plc announced new results from the Medtronic Micra Transcatheter Pacing System (TPS) Global Clinical Trial in...
Overlay Init