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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EFor patients at high risk of complications with standard surgical endarterectomy therapy, carotid stenting with distal embolic protection yields low event rates and low incidence of device failure, according to the results of CAPTURE (Carotid ACCULINK\/ACCUNET Post Approval Trial to Uncover Rare Events).\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Eclinical trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Einterventional\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\n         \n         \u003Cp id=\u0022p-2\u0022\u003EFor patients at high risk of complications with standard surgical endarterectomy therapy, carotid stenting with distal embolic protection yields low event rates and low incidence of device failure, according to the results of CAPTURE (Carotid ACCULINK\/ACCUNET Post Approval Trial to Uncover Rare Events).\u003C\/p\u003E\n         \u003Cp id=\u0022p-3\u0022\u003ECarotid artery disease accounts for about 25% of the strokes reported in the US, stated CAPTURE investigator William Gray, MD, associate professor of clinical medicine at Columbia University Medical Center. CAPTURE is a post-market FDA-mandated registry of the Guidant RX Acculink Carotid Stent System with the RX Accunet Embolic Protection System. The purpose of which is to evaluate \u201creal-world\u201d use of the devices and to monitor malfunctions. The trial registry now includes 2500 patients enrolled at 188 centers treated by 240 physicians with moderate levels of experience. The primary endpoint is the composite of death, stroke or myocardial infarction (MI), at 30 days after stent placement Gray said.\u003C\/p\u003E\n         \u003Cp id=\u0022p-4\u0022\u003EThe preliminary report of 1600 patients from CAPTURE presented at last year\u0027s Transcatheter Cardiovascular Therapeutics meeting suggested that carotid artery stenting improves outcomes in this high-risk population of patients with plaque build-up in the arteries supplying blood to the brain. In this earlier analysis, the primary combined endpoint occurred in 5.7% of patients.\u003C\/p\u003E\n         \u003Cp id=\u0022p-5\u0022\u003E\u201cA nearly 3% reduction in primary combined endpoint compares favorably to the 8.3% event rate in the pivotal nonrandomized ARCHER (ACCULINK for Revascularization of Carotids in High-Risk Patients) trial leading to FDA approval for the Guidant device,\u201d Gray stated. This difference was primarily due to lower rate of myocardial infarction in asymptomatic lower risk patients. In addition it compares favorably to the 14.5% event rate in high risk patients in the surgical trials. Asymptomatic patients appeared to benefit, with a combined 4.5% incident rate at 30 days and risk of stroke of 3.5%. Acceptable event rates for asymptomatic patients is under 3%. Risk for patients \u0026lt;80 years was 3.5%, a rate comparable to endarterectomy rates in low risk patients over the last decade. Risk for those 80 years was higher, but similar regardless of symptom status, Gray said. Patients with diabetes, smokers and females all had relatively low risk of stroke\/death\/MI. Low event rates were also in centers with low procedure volume.\u003C\/p\u003E\n         \u003Cdiv id=\u0022F1\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/6\/1\/23\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-1279943598\u0022 data-figure-caption=\u0022\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure1\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/6\/1\/23\/F1.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/6\/1\/23\/F1.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure1\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/6\/1\/23\/F1.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/16093\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\n         \u003Cp id=\u0022p-6\u0022\u003EDevice malfunctions were few (0.2%), and none occurred after the filter was modified halfway through CAPTURE. Gray noted that while asymptomatic high-risk patients are not covered for carotid stenting under CMS (The Center for Medicare \u0026amp; Medicaid Services) he anticipates reassessment by CMS based on these results.\u003C\/p\u003E\n         \u003Cp id=\u0022p-7\u0022\u003E\u201cThe transfer of carotid stenting technology from clinical trial sites to clinical practice sites appears to have been successful with the same, or even better, outcomes in the clinical setting,\u201d Gray concluded.\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2006 MD Conference Express\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/6\/1\/23.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_figures.js?nzm6j1\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzm6j1\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}