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At least 505 records · Page 28Linked to original sources
PubMed2005

[Sixty-four cases of percutaneous coronary angioplasty on saphenous vein bypass grafts].

OBJECTIVE: To evaluate the early clinical result of percutaneous transluminal coronary intervention (PCI) and stenting on saphenous vein grafts. METHODS: Percutaneous intervention was performed in 91 saphenous vein grafts in 64 patients. The data of clinical results during operation and hospitalization and that of other interventional assisting device were recorded in database and were analyzed. RESULTS: The success rate of operation was 95.3%, non-Q wave myocardial infarction occurred in 1 patient (1.6%) and temporary no-reflow phenomenon occurred in 4 patients (6.3%) during operation. Reduced antegrade flow and ventricular fibrillation happened in 1 patient after stenting and normal antegrade flow obtained after cardiac compression and tracheal intubation and insertion of IABP. The distal protection devices were used in 7 patients (10.9%), X-sizer extraction system in 4 patients. Platelet glycoprotein IIb/IIIa receptor blockers were administered in 25 patients (35.9%). Non-Q wave myocardial infarction occurred in two cases, the incidence of major adverse clinical event was 3.1% during the period of hospitalization. CONCLUSIONS: The instant success rate of PTCA and stenting of saphenous vein bypass grafts is high and recent clinical result is promising, but the middle and long term results remain to be further followed. The use of distal embolic protection device and GPIIb/IIIa receptor blockers may improve its prognosis.

Aged↗
PubMed2004

Modified ileal neobladder for continent urinary diversion: functional results after 9 years of experience.

PURPOSE: We report the continence status and urodynamic findings in 59 patients who underwent radical cystectomy and orthotopic bladder reconstruction using a modified S-ileal neobladder technique between January 1993 and July 2002. MATERIALS AND METHODS: Continence status was assessed using patient interview, frequency-volume charts and the need for protective devices. Reservoir sensation, compliance, capacity and activity were assessed by enterocystometry. Post-void residual urine volume greater than 100 ml was the indication for clean intermittent self-catheterization. RESULTS: Daytime continence was reported by 95.5% and 100% of our patients at 1 and 5 years, respectively. Overall, 77.7% of patients reported nighttime continence at 1 year and 96.5% at 5 years. The need for a protective device decreased with time and most of the patients would have undergone the operation again. Enterocystometric capacity and maximum reservoir pressure remained remarkably stable at 391.6 versus 440 ml, and 30 versus 20 cm H2O, 6 months and 5 years after surgery, respectively. Nevertheless, median post-void residual urine volume increased from 35 ml at 6 months to 55 ml at 5 years with an increase in prevalence of patients requiring intermittent self-catheterization due to post-void residual urine greater than 100 ml from 1.8% at 6 months to 10% at 5 years. CONCLUSIONS: Orthotopic bladder substitution with the modified S-ileal neobladder technique has an excellent functional outcome over time, resulting in high daytime and nighttime continence levels as well as high acceptability rates from our patients.

Aged↗
PubMed1996

Glutathione transferase activity and formation of macromolecular adducts in two cases of acute methyl bromide poisoning.

OBJECTIVES: To determine the activity of glutathione transferase and to measure the S-methylcysteine adducts in blood proteins, after acute inhalation exposure to methyl bromide. To examine the influence of the polymorphism of glutathione-S-transferase theta (GSTT1) on the neurotoxicity of methyl bromide. METHODS: Two workers acutely exposed to methyl bromide with inadequate respiratory protective devices were poisoned. Seven weeks after the accident, blood samples were drawn from both patients, for measurement of glutathione transferase activity in erythrocytes (conjugator status--that is, GSTT1 phenotype) and measurement of binding products of methyl bromide with blood proteins. Conjugator status was determined by a standard procedure. The binding product of methyl bromide, S-methylcysteine, was measured in globin and albumin. RESULTS: Duration and intensity of exposure were identical for both patients as they worked together with the same protective devices and with similar physical effort. However, one patient had very severe poisoning, whereas the other only developed mild neurotoxic symptoms. The first patient was a "conjugator" with normal glutathone transferase activity, whereas this activity was undetectable in the erythrocytes of the second patient, who consequently had higher concentrations of S-methylcysteine adduct in albumin (149 v 91 nmol/g protein) and in globin (77 v 30 nmol/g protein). CONCLUSIONS: Methyl bromide is genotoxic and neurotoxic. Its genotoxicity seems to be the consequence of the alkylating activity of the parent compound, and conjugation to glutathione has a protective effect. The data presented here suggest a different mechanism for methyl bromide neurotoxicity which could be related to the transformation of methylglutathione into toxic metabolites such as methanethiol and formaldehyde. If such metabolites are the ultimate toxic species, N-acetylcysteine treatment could have a toxifying rather than a detoxifying effect.

Acute Disease↗
PubMed2002

Percutaneous treatment for carotid stenosis.

Stroke is the leading cause of serious long-term disability in the United States. A substantial portion of strokes are caused by atherosclerotic carotid artery disease. The conventional risk factors for coronary atherosclerosis are also responsible for carotid atherosclerosis. Carotid stenosis is encountered in medical practice in either symptomatic or asymptomatic states. In symptomatic patients, medical management with antiplatelet agents does not provide adequate protection against stroke. Carotid endarterectomy can help reduce the risk of a subsequent stroke. Asymptomatic patients with severe carotid stenosis can also benefit from surgical intervention if endarterectomy can be performed at a low operative risk. In recent years, percutaneous carotid stenting using self-expanding stents has become popular for the treatment of carotid stenosis. Although this initial experience has been reported from a high-risk patient population, the results are encouraging, with acceptable periprocedural stroke rates. Moreover, emboli protection devices, modern adjuvant pharmacotherapy, and modern self-expanding stents were not utilized in these studies. With rapidly expanding technology and advances in interventional pharmacology, improvement of clinical outcome is likely. Table 3 summarizes current recommendations for carotid stenting based on a panel of cardiologists, radiologists, and vascular surgeons. At this stage, randomized trials to compare endarterectomy with carotid stenting are underway. Cautious optimism is necessary until the optimal equipment, emboli protection devices, and adjuvant pharmacotherapies are fully investigated. Until then, carotid stenting should be restricted to high-risk candidates for carotid endarterectomy, including patients with severe cardiac comorbidities, previous neck surgeries or radiation, restenosis after endarterectomy, or other technical contraindications for surgery.

Angioplasty↗
PubMed1994

Controlled release insecticide devices for protection of sheep against head strike caused by Lucilia cuprina.

The effectiveness of polymer matrix tags containing (w/w) 8.5% cypermethrin, 7.5% flucythrinate, 13.7% tetrachlorvinphos or 20.0% diazinon in protecting sheep against head strike by the sheep blowfly (Lucilia cuprina Wiedemann) was investigated in larval implant, fly cage and field studies. Tags impregnated with cypermethrin reduced the total number of egg masses deposited on the heads of sheep in fly cage studies over a 6 week period by 73.3% compared with no treatment. Tags impregnated with flucythrinate reduced the number of egg masses by 25.3% over 21 weeks but there were no significant differences (P < 0.05) between treated and untreated sheep at individual exposures. Egg masses were found on the majority of tagged sheep and no protection was provided against implants with first instar L. cuprina larvae by either cypermethrin or flucythrinate tags. Tags impregnated with diazinon gave longer protection than treatment with a liquid formulation containing 400 ppm diazinon in larval implant, fly cage and field studies. Over a 12 week period in field studies, 6.6% of rams treated with diazinon tags became struck compared with 30% treated by diazinon jetting, 35.7% treated with plastic tags not impregnated with insecticide and 24.2% of untreated rams. When the rams were exposed to high populations of L. cuprina in an exposure house from 13 to 18 weeks after treatment, 3.3% of rams treated with diazinon tags, 57.1% treated by diazinon jetting, 43.8% treated with plastic tags and 23.5% of untreated rams became struck. Most strikes in the diazinon tagged sheep occurred at sites which were not contacted by the tags. Tags impregnated with tetrachlorvinphos reduced the number of strikes in comparison with no treatment in larval implant and fly cage studies but the results were inconsistent and not as good as those from diazinon tags. It is concluded that well designed controlled release devices that reliably contact the wool on the heads of sheep at sites of flystrike risk and which are able to withstand damage from rams fighting may be able to give prolonged protection against head strike.

Administration, Topical↗
PubMed2006

EMERALD, AIMI, and PROMISE: is there still a potential for embolic protection in primary PCI?

The recent trials of routine use of embolic protection devices for primary percutaneous coronary interventions (PCI) (the EMERALD, PROMISE, and AIMI trials) have demonstrated neutral or even negative effects of these devices on myocardial reperfusion and final infarct size. Despite these results, there is still ground to believe that PCI-induced embolization may be clinically relevant in specific subsets of patients with acute myocardial infarction (AMI). Significant clinical consequences may be expected when embolization is quantitatively relevant and/or is qualitatively characterized by lipid-rich athero-embolism (as is the case of lipid core embolization through the ruptured cap of a fibro-atheroma). Future trials on embolic protection devices in primary PCI should adopt a selective, rather than a routine strategy, through the identification, by angiographic or intravascular imaging parameters, of patients at highest risk of clinically relevant embolization. Such trials should also adopt specific endpoints able to evaluate the effect of micro-embolization, which is currently far from optimally assessed by the standard markers of myocardial reperfusion.

Angioplasty, Balloon, Coronary↗
PubMed2003

[Air-borne disease].

Respiratory protection is a factor which worries nursing professionals who take care of patients susceptible of transmitting microorganisms through the air more as every day passes. This type of protection covers the use of surgical or hygienic masks against the transmission of infection by airborne drops to the use of highly effective masks or respirators against the transmission of airborne diseases such as tuberculosis or SARS, a recently discovered disease. The adequate choice of this protective device and its correct use are fundamental in order to have an effective protection for exposed personnel. The authors summarize the main protective respiratory devices used by health workers, their characteristics and degree of effectiveness, as well as the circumstances under which each device is indicated for use.

Air Microbiology↗
PubMed2005

Carotid artery stenting in clinical practice results from the Carotid Artery Stenting (CAS)-registry of the Arbeitsgemeinschaft Leitende Kardiologische Krankenhausarzte (ALKK).

BACKGROUND: Carotid artery stenting (CAS) for symptomatic and asymptomatic carotid stenosis seems to be on the doorstep of more widespread use. However, its feasibility and safety in clinical practice at a broad spectrum of hospitals needs to be determined. METHODS: We analyzed data of the prospective multi-centre Carotid Artery Stenting (CAS) Registry of the German Arbeitsgemeinschaft Leitende Kardiologische Krankenhausarzte (ALKK). RESULTS: From 7/1996 to 5/2004 1888 patients from 28 hospitals were included in the CAS Registry. The median hospital stay from CAS until hospital discharge was 3 days (quartiles: 2-6 days). Median patients age was 70 years (quartiles: 64-76 years) with 72.1% males. CAS for symptomatic stenosis was performed in 55% of cases. Patients treated with CAS suffered from coronary artery disease in 66.5%, had arterial hypertension in 91.7%, hyperlipidemia in 86.3% and 34.2% were diabetics. The intended CAS procedure was completed in 98.1% of cases. A stent was implanted in 97.3% of completed cases. The median intervention time was 43 min (quartiles: 30-60 min). During the hospital stay death rate was 0.3% (5/1888) and the rate of ipsilateral stroke 3.2% (58/1840). A contralateral ischemic event occurred in 1.4% (26/ 1840) of patients. The combined rate of all death or strokes was 3.8% (70/1841). Between 1996 and 2004 there was a steady increase in the use of protection devices during CAS (0% in 1996 and 97.9% in 2004; p for trend <0.0001). There was also an increase in the proportion of patients treated for asymptomatic stenoses (p for trend <0.0001). We observed a decrease of the combined endpoint of death or stroke from 6.3% in 1996 to 1.9% in 2004 (p for trend=0.021). CONCLUSION: The multi-centre ALKK CAS Registry data confirm the feasibility and shot-term safety of CAS even in daily clinical practice. There was a rapid penetration of the use of embolic protection devices, an increase in treatment of asymptomatic carotid stenoses and a decrease in acute complication rates from 1996 to 2004.

Aged↗
PubMed1996

Surveillance of deaths on board Danish merchant ships, 1986-93: implications for prevention.

OBJECTIVE: To describe and analyse the types and circumstances of all natural and non-natural deaths among seamen on board Danish merchant ships. METHODS: Data on 147 cases were obtained from maritime authorities, an insurance company, shipping companies, hospitals, death registers, and death certificates in the period from 1986-93. RESULTS: The 53 natural deaths were dominated by cardiovascular diseases and infectious diseases. Insufficient treatment on board was identified as a contributing factor for death in some cases. Medical advice was not always sought and the advice given was in some cases insufficient. 73 fatal accidents were identified. The incidence of accidents of 5.29/10,000 person-years was 11.5 times higher than the incidence of 0.46/10,000 for the Danish male workforce ashore. 23 accidents (31%) were due to maritime casualties and 26 (36%) were occupational accidents. The remaining 24 (33%) were accidents during off duty hours including six self intoxications. Rough weather, inadequate awareness of safety, lack of use of personal protection devices, and inexperience were associated with many of the fatal injuries directly related to work. Alcohol played a major part in 12 out of 18 fatal injuries occurring during off duty hours. CONCLUSIONS: The maritime workplace was identified as a high risk workplace and in many aspects differs from the conditions ashore. Acute diseases and serious injuries pose special risks to seamen because of a lack of direct access to professional medical care at sea. Primary prevention of certain diseases is needed and possible. Improved training, improved systems of work, improved safety awareness, and greater use of personal protection devices are needed to prevent fatal injuries. Medical training of ships' officers providing medical care on board and specific training of doctors giving medical advise to ships should be improved to meet the needs.

Accidents, Occupational↗
PubMed2006

Acute and mid-term local vascular effects of compliant balloon inflation (GuardWire system) on saphenous vein bypass grafts: an angiographic analysis.

BACKGROUND: The GuardWire distal protection device reduces the incidence of periprocedural complications during percutaneous stenting of diseased saphenous vein grafts. Its mechanism of action is based on the occlusion of the vessel distal to the lesion with an inflated compliant balloon before the intervention, and the aspiration of embolized material after stent implantation. Although no safety issues related to the compliant balloon have been reported in vein graft treatment, concerns related to the potential injury of the balloon on the vessel wall have been raised. We thus evaluated the angiographic outcome of the vein graft segment where the compliant balloon of the GuardWire distal protection device was inflated during percutaneous interventions of diseased vein grafts. METHODS: Forty consecutive patients undergoing vein graft stenting, all with successful delivery of the GuardWire system, were enrolled. All patients underwent 6-months follow-up angiography. Quantitative coronary angiographic analysis of the vein graft segment where the balloon was inflated was performed before and after the procedure, as well as at 6-month follow-up. RESULTS: No differences in reference vessel diameter, minimal luminal diameter and diameter stenosis were evident between the three measurements. In particular, the difference between post-procedural and follow-up minimal luminal diameter (namely late loss) was 0.003+/-0.19 mm (95% confidence interval: -0.06-0.06). CONCLUSIONS: This prospective study supports for the first time the "angiographic safety" of low pressure inflations of a compliant balloon in saphenous vein grafts, suggesting the absence of acute and mid-term effects on the vein graft vessel wall.

Aged↗
PubMedDate not supplied

Extracranial carotid artery stenting in surgically high-risk patients using the Carotid Wallstent endoprosthesis: midterm clinical and ultrasound follow-up results.

The purpose of this study was to evaluate the feasibility, safety and midterm outcome of elective implantation of the Carotid Wallstent in patients considered to be at high surgical risk. In a prospective study, 54 carotid artery stenoses in 51 patients were stented over a 24-month period. Three patients underwent bilateral carotid artery stenting. Institutional inclusion criteria for invasive treatment of carotid occlusive disease (carotid endarterectomy or carotid artery stenting) are patients presenting with a 70% or more symptomatic stenosis and those with an 80% or more asymptomatic stenosis having a life-expectancy of more than 1 year. All patients treated by carotid artery stenting were considered at high risk for carotid endarterectomy because of a hostile neck (17 patients--31.5%) or because of severe comorbidities (37 patients--68.5%). No cerebral protection device was used. Of the 54 lesions, 33 (61.1%) were symptomatic and 21 (38.8%) were asymptomatic. Follow-up was performed by physical examination and by duplex ultrasonography at 1 month, 6 months, 1 year and 2 years after the procedure. All 54 lesions could be stented successfully without periprocedural stroke. Advert events during follow-up (mean 13.9 +/- 5.7 months) were non-stroke-related death in 6 patients (11.1%), minor stroke in 4 stented hemispheres (7.4%), transient ipsilateral facial pain in 1 patient (1.8%), infection of the stented surgical patch in 1 patient (1.8%) and asymptomatic instent restenosis in 4 patients (7.4%). The percutaneous implantation of the Carotid Wallstent, even without cerebral protection device, appears to be a safe procedure with acceptable clinical and ultrasonographic follow-up results in patients at high surgical risk. But some late adverse events such as ipsilateral recurrence of non-disabling (minor) stroke or instent restenosis still remain real challenging problems.

Aged↗
PubMed2003

[Radiation doses deriving from patients treated with (166)Ho-ferric hydroxide].

AIM: To estimate radiation doses deriving from patients treated with (166)Ho ferric hydroxide. METHODS: For radiation synoviorthesis about 900 +/- 100 MBq (166)Ho ferric hydroxide was injected into the knee joint of 16 patients. To estimate the radiation exposure of persons in the neighbourhood of the patients measurements of the dose rates were performed at 0.5 m, 1 m and 2 m distance of the treated joint 10 min after tracer injection. Measurements were carried out with and without radiation protection devices of the syringe. RESULTS: The initial values of the dose rate were 11.9 micro Sv/h at 0.5 m, 3.5 micro Sv/h at 1 m and 1 micro Sv/h at 2 m distance, respectively. The whole body doses were 2.9 micro Sv for the physician and 4.6 micro Sv for the technologist. The finger doses for the technologist and the physician were ranging from 65 to 111 micro Sv. After discharge at home other persons might receive 118 micro Sv. CONCLUSION: Our results, under very strict assumptions, clearly demonstrate that the calculated radiation exposure to medical and non medical personnel is well below the maximum annual dose limit. The use of any additional radiation protection device as syringe shielding does not significantly lower radiation exposure.

Fingers↗
PubMed2001

[Cerebral protection with balloon occlusion during carotid artery stent implantation--first experiences].

PURPOSE: To assess the technical feasibility and the results of cerebral protection with the GuardWire Plus Temporary Occlusion & Aspiration System during carotid artery stenting for high-grade stenosis. PATIENTS AND METHODS: In 20 patients 20 carotid artery stenoses were treated with stent placement under cerebral protection. A contralateral carotid occlusion was an exclusion criteria for the use of the protection device. In all cases only aspiration, but no flushing was used before deflation of the occlusion balloon. In 17 of 20 patients diffusion-weighted (DW-)MRT imaging of the brain was performed before and 24 hours after the procedure. RESULTS: The stent implantation was successfully performed in all patients. In 3 patients neurologic symptoms occurred during the occlusion time. In these 3 patients the symptoms immediately disappeared after deflation of the balloon. In one case there was dilatation of the internal carotid artery at the site of the balloon inflation. In 3 of the 17 DW-MR images new ipsilateral cerebral lesions, in one case a new contralateral lesion occurred after the procedure. CONCLUSIONS: The cerebral protection procedure is technically feasible. The occlusion of the internal carotid artery was not tolerated by all patients. The DW-MR imaging demonstrated cerebral lesions indicating the occurrence of cerebral microemboli during the procedure. Further investigations are necessary to determine if the use of the cerebral protection device will improve the results of the carotid artery stenting for high-grade stenoses.

Aged↗
PubMed2005

Efficacy of sirolimus-eluting stents compared with bare metal stents for saphenous vein graft intervention.

Saphenous vein graft (SVG) intervention is associated with a significantly increased rate of periprocedural complications and late clinical and angiographic restenosis. We examined the efficacy and safety of sirolimus-eluting stents (SESs; Cypher) compared with bare metal stents (BMSs) in SVG intervention. Forty-eight patients who had 50 SVG lesions and underwent standard percutaneous coronary intervention with SESs (SES group) were compared with 57 patients who had 64 SVG lesions and underwent intervention with BMSs (BMS group). All patients received distal protection devices during SVG intervention. In-hospital, 30-day, 6-month, and 1-year clinical outcomes in the 2 groups were compared. Baseline clinical and procedural characteristics were balanced between groups. There were no deaths or Q-wave myocardial infarctions during the index hospitalization, but compared with the BMS group, patients in the SES group had significantly fewer non-Q-wave myocardial infarctions (4% vs 21%, p = 0.01), which was mainly attributed to increased periprocedural creatine kinase-MB levels. At 30-day, 6-month, and 1-year follow-ups, all clinical outcomes were similar between groups. Event-free survival at 1 year was also similar between groups (p = 0.84). In conclusion, the use of SESs in patients who undergo SVG intervention with a distal protection device is clinically safe and feasible but is not associated with decreased clinical events up to 1 year compared with BMSs.

Aged↗
PubMed1989

A study on the usage of respirators among granite quarry workers in Singapore.

The frequency and correctness of respirators were studied in 5 granite quarries in Singapore involving 201 workers. The overall prevalence of usage of correct respirators was 45.8%. 10.4% of the workers were found to be using the wrong respiratory protective devices. Age, years of exposure and types of occupations were found to affect the usage of respirators. Some common reasons given by workers for not wearing the respirators were 'breathing difficulty', 'hot & sweaty', and 'respirator smells after a while'.

Adult↗
PubMed1995

[An overview of snow-boarding injuries].

Snowboarding is increasing dramatically in popularity in Switzerland as well as other countries. Work aimed at improving the design of the boards and of the boots and bindings has also increased rapidly during recent years. Most injured snowboarders are fit young men and boys who describe themselves as beginners and have had a minimal amount of instruction at an officially approved training centre. Appropriate snowboard training has mostly been quite inadequate, and protective devices (e.g. waterproofed support gloves). The anatomical distribution and the types of injuries sustained in snowboarding differ from those in alpine skiing. The wrist (and forearm) and the ankle are the most frequent locations of injuries (23%) as against the knee and thumb in alpine skiing. Sprains and strains were the most frequent types of injuries (46%), followed by fractures (28%) and contusions (13.5%). The snowboard injury rate was higher than in alpine skiing (1.7-8/1000 snowboard days versus 2-4/1000 ski days). Falling forward on the slope was the major mechanism of injury (80%), and torsion the next most frequent (20%). Snowboarding injuries were sustained most often on ice and hardpacked snow, compared with soft powder snow for alpine skiing injuries. Appropriate preseason conditioning, snowboarding lessons from a certified instructor, appropriate selection of rigorously tested equipment and use of protective devices are the main steps that must be taken to prevent injuries.

Adolescent↗
PubMed1997

Eye protection for newborns under phototherapy: comparison between a modified headbox and the conventional eyepatches.

In a randomized trial comparing a modified oxygen headbox with conventional eye patches for protecting the eyes of newborn infants undergoing phototherapy, the use of the headbox did not interfere with phototherapy treatment and was preferred by the nursing staff, as shown by an opinion survey. This, plus our previously reported finding that the headbox was associated with less eye infection, less periorbital skin irritation and less accidental exposure of the eyes due to displacement of the protective devices, suggests that the headbox provides a convenient and inexpensive alternative method of eye protection. The device may be particularly useful in busy and under-staffed neonatal units where vigilant eye care of infants undergoing phototherapy may be difficult.

Attitude of Health Personnel↗
PubMedDate not supplied

Complications and follow-up after unprotected carotid artery stenting.

PURPOSE: This prospective study was undertaken to determine the success rate, complications, and outcome of carotid artery stenting (CAS) without the use of cerebral protection devices. METHODS: During 12 months, 94 high-grade stenoses of the carotid artery in 91 consecutive patients were treated. Sixty-six (70%) of the stenoses were symptomatic and 28 (30%) were asymptomatic. RESULTS: In all 94 carotid stenoses CAS was successfully performed. During the procedure and within the 30 days afterwards, there were 2 deaths and 3 major strokes in the 66 symptomatic patients, resulting in a combined death and stroke rate of 5 of 66 (7%). Only one of these complications, a major stroke, occurred during the procedure. In the 6-month follow-up, one additional major stroke occurred in a originally symptomatic patient resulting in a combined death and stroke rate of 6 of 66 (10%) for symptomatic patients at 6 months. No major complications occurred in asymptomatic patients during the procedure or in the 6-month follow-up period. At 6 months angiographic follow-up the restenosis rate with a degree of >50% was 3 of 49 (6%) and the rate with a degree of >or=70% was 1 of 49 (2%). CONCLUSIONS: Cerebral embolization during CAS is not the only cause of the stroke and death rate associated with the procedure. The use of cerebral protection devices during the procedure may therefore not prevent all major complications following CAS.

Adult↗