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Acta Neurochirurgica

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01-12-2012 | Clinical Article

Historical perspective of carotid artery stenting in Japan: Analysis of 8,092 cases in The Japanese CAS survey

Authors: Shigeru Miyachi, Waro Taki, Nobuyuki Sakai, Ichiro Nakahara, The Japanese CAS Survey Investigators

Published in: Acta Neurochirurgica | Issue 12/2012

Abstract

Background and purpose

We conducted a large retrospective survey of the clinical results of carotid artery stenting (CAS) for about 10 years performed by neurointerventionists at 43 Japanese institutions. Hence, the historical perspective of CAS in Japan was demonstrated.

Methods

Cases were stratified into three separate periods based on the approval status of devices: the first period, in which off-label CAS was performed using balloon protection; the second period, using a limited number of approved devices under filter protection; the third period, using appropriate protection selected from several different options based on the preoperative evaluation (tailored CAS). Clinical results were retrospectively evaluated. Then 30-day results of each period were examined. The major adverse event (MAE) was defined as stroke, myocardial infarction or death.

Results

Between January 2001 and December 2010, a total of 8,092 cases were registered, including 4,072, 1,526 and 2,494 in the first, second and third period, respectively. In the first period, 92 % of CAS was performed under balloon protection. In contrast, 91 % was done under filter protection in the second period. In the third period, various protection methods were used, including balloon (31 %), filter (50 %) and proximal protection (18 %). The rate of MAE at 30 days was 6.1 %, 10.2 % and 3.5 % in the first, second and third periods, respectively, and 6.3 % in all periods combined. The rate of MAE in the third period was significantly lower than that in the first and second periods.

Conclusions

The historical paradigm of CAS in Japan was demonstrated. Due to the improvement of devices, increasing experience and appropriate selection of protection, CAS is continuing to evolve into a safer and more efficacious method of stroke prevention.

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Title: Historical perspective of carotid artery stenting in Japan: Analysis of 8,092 cases in The Japanese CAS survey
Authors: Shigeru Miyachi
Waro Taki
Nobuyuki Sakai
Ichiro Nakahara
The Japanese CAS Survey Investigators
Publication date: 01-12-2012
Publisher: Springer Vienna
Published in: Acta Neurochirurgica / Issue 12/2012
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-012-1508-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Historical perspective of carotid artery stenting in Japan: Analysis of 8,092 cases in The Japanese CAS survey

Abstract

Background and purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background and purpose

Methods

Results

Conclusions

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