@article{oai:nagasaki-u.repo.nii.ac.jp:00017916,
 author = {Hayashi, Kentaro and Kitagawa, Naoki and Morikawa, Minoru and Hiu, Takeshi and Morofuji, Yoichi and Suyama, Kazuhiko and Nagata, Izumi},
 issue = {5},
 journal = {Surgical Neurology},
 month = {Nov},
 note = {Background: Carotid artery stenting (CAS) in high-surgical-risk patients is considered as an effective alternative to carotid endarterectomy. Since the occurrence of distal embolization with CAS is still major concern, embolus protection device is usually employed during the procedure. We developed a technique for observation of embolus protection filter and evaluate the debris or thrombus microscopically, and the pathological findings were compared with preoperative imaging studies.
Patients and Methods: After completing CAS, filter membrane was stained with hematoxylin & eosin (HE) solution and removed from filer strut. Mounting onto a glass slide, filter was evaluated under microscope. Plaque debris and appearance of filter membrane were evaluated and the covered area was measured. The pathological findings were compared with preoperative imaging studies.
Results: Microscopical observation of the slide revealed atheromatous debris as well as thrombotic material to the filter membrane. HE stain facilitates the characterization of the debris composition, namely thrombotic debris, calicified debris, organized debris, fibrous debris, lipid-rich debris. The subtypes of debris were consistent with preoperative imaging studies. Thus. in cases of intraprocedural flow impairment, more than 50% of filter area was covered with debris or thrombotic material.
Conclusion: Carotid plaque debris captured during carotid stenting with protection filter can be visualized with HE stain on the glass side. This simple method allows us to better understand plaque debris and appearance of embolus protection filter., Surgical Neurology, 72(5), pp.532-537; 2009},
 pages = {532--537},
 title = {Observation of the embolus protection filter for carotid artery stenting},
 volume = {72},
 year = {2009}
}