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P194 Purpose: From the results of high-quality  prospective randomized trials it has been apparent that symptomatic CA  stenosis &gt; 60–70% lead to a significant incidence of stroke if  treated medically. Angioplasty and stenting is increasingly performed  in the carotid artery and its most feared complication is distal emboli  of dislodged plaque debris. We present, the partial results of  CAFÉ protocol (Carotid Angioplasty-stenting Free of Emboli, a  prospective multicentric study) of carotid angioplasty using a cerebral  protection newly designed device in a single center. Clinical Material  andMethods: The patient population was composed of 50  patients with 55 target lesions; 30 men and 20 women, with ages ranging  from 51–84 (mean 60,6 years). All the patients presented at least 2  risk factors. 82.5 of the lesions were symptomatic. Before the  procedure, cranial CT / MRI, cervical US and DSA of supraaortic vessels  and cerebral parenchymography were performed. Stenosis were evaluated  according to NASCET criteria. Mean stenosis: 79 %. Calcic plaque:  65%. Ulcerated plaque: 60 %. Associated lesions in supraaortic  vessels: 45%. Mean lesion length: 21.1 mm.Results: The  balloon-guidewire was able to successfully cross the lesion in all the  cases. Mean balloon occlusion time was 10 min. The immediate  angiographic result demonstrated residual stenosis of 0–20% in all  the cases. Operative morbidity: bradychardia, 7 cases (12.7%); balloon  intolerance, 2 cases (3.6%). 22 patients (44%) were followed  clinically for more than 12 months. Postoperative morbidity: myocardial  infarction, 1 case (2%); congestive heart failure, 1 case (2%). The  mortality rate is 0%.Conclusions: Cerebral protection  represents a major contrubution to carotid artery angioplasty and  stenting technique reducing significantly the occurrence of procedural  emboli.

Preliminary Experience in Carotid Artery Angioplasty and Stenting with a New Cerebral Protection Device.