Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:


Capture study shows safety of carotid stenting in 'real-world' setting

With appropriate training, community physicians achieve gratifying results

The largest-ever study of carotid stenting in high-surgical risk patients has shown that with proper education and training, community physicians are just as successful at using catheter-based techniques to unclog arteries supplying blood to the brain as are those who pioneered the procedure at major university medical centers.

The study was released online today at, and will be published in the January 2007 issue of Catheterization and Cardiovascular Interventions: Journal of the Society for Cardiovascular Angiography and Interventions.

The CAPTURE study (short for Carotid ACCULINK/ACCUNET Post- Approval Trial to Uncover Unanticipated or Rare Events) involved 3,500 patients at increased surgical risk for carotid endarterectomy and 353 physicians at 144 hospitals across the United States. It addressed several questions critical to the evaluation of any new technology, among them: Could carotid stenting safely make the leap to "real-world," everyday use, or would the technique prove beneficial only in the hands of expert physicians"

"The ability to transfer the technology to the community was successful," said Dr. William A. Gray, Director of Endovascular Services and an Associate Professor of Clinical Medicine at Columbia University in New York City. "The study involved multiple physician specialties, multiple experience levels, and multiple sites with very broad geographic representation, and demonstrated that regardless of these differences, outcomes were similar across the board."

In carotid stenting, a physician threads a catheter through a small puncture in a leg artery and into the narrowed artery in the neck, which feeds blood to the brain. A filter is placed through this catheter and expanded above the blockage to protect the brain during the procedure. A flexible and crush-resistant stent is positioned in the blockage and then expanded with a balloon to hold the artery open. Once the procedure is complete, the filter is collapsed and removed.

The Rx Acculink carotid stent and its companion, the Rx Accunet filter, were approved by the Food and Drug Administration (FDA) in 2004 for the treatment of patients who not only have severe plaque build-up in the arteries in the neck—a condition that hikes the risk of stroke—but other medical problems that make it risky to have the plaque removed surgically. The CAPTURE registry was developed to collect FDA-mandated data to assess the ongoing safety of the Rx Acculink and Rx Accunet devices in a large group of patients, as well as the effectiveness of a training program tailored to the experience level of each physician interested in performing carotid stenting.

The study was well designed, with patients undergoing a neurological examination before the procedure, 24 hours afterward, and at 30 days. In addition, the physicians who examined patients for complications were independent of those who performed the stenting procedure. This latter aspect of the study is one of its major strengths, said Dr. Christopher J. White, editor-in-chief of Catheterization and Cardiovascular Interventions. "Because independent observers measured the outcomes of the procedure, we can have confidence that the data are robust, meaningful, and applicable in community practices," Dr. White said.

CAPTURE data revealed no unexpected problems with the carotid stenting devices themselves. In addition, patients fared equally well whether treated by highly experienced physicians or those who were new to carotid stenting but had undergone intensive training and on-site mentoring during their first few procedures. The combined rates of death, heart attack, and stroke were 6.3 percent overall—5.3 percent among the most experienced physicians, 6.0 percent among those with a moderate level of experience, and 7.4 percent among those with little previous experience, differences that were not statistically significant.

Carotid stenting experts hope such data will persuade the Centers for Medicare and Medicaid Services (CMS) to expand coverage for carotid stenting. For now, Medicare coverage is available only for patients who are at high risk for surgery and have symptoms before the procedure, but not those who are symptom-free despite severely narrowed carotid arteries. CMS is now re-evaluating that policy in light of data from CAPTURE and other post-market surveillance studies.

"What we’re really working toward is providing patients with greater access to the technology, where we think it is appropriate," Dr. Gray said.

"The CAPTURE trial is a giant step toward achieving the goal of proving that, in the foreseeable future, nonsurgical carotid stent placement will replace surgery as the treatment of choice for stroke prevention," said Dr. White.

Wayne Powell | EurekAlert!
Further information:

More articles from Studies and Analyses:

nachricht Rutgers-led innovation could spur faster, cheaper, nano-based manufacturing
14.02.2018 | Rutgers University

nachricht New study from the University of Halle: How climate change alters plant growth
12.01.2018 | Martin-Luther-Universität Halle-Wittenberg

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Space observation with radar to secure Germany's space infrastructure

Satellites in near-Earth orbit are at risk due to the steady increase in space debris. But their mission in the areas of telecommunications, navigation or weather forecasts is essential for society. Fraunhofer FHR therefore develops radar-based systems which allow the detection, tracking and cataloging of even the smallest particles of debris. Satellite operators who have access to our data are in a better position to plan evasive maneuvers and prevent destructive collisions. From April, 25-29 2018, Fraunhofer FHR and its partners will exhibit the complementary radar systems TIRA and GESTRA as well as the latest radar techniques for space observation across three stands at the ILA Berlin.

The "traffic situation" in space is very tense: the Earth is currently being orbited not only by countless satellites but also by a large volume of space...

Im Focus: Researchers Discover New Anti-Cancer Protein

An international team of researchers has discovered a new anti-cancer protein. The protein, called LHPP, prevents the uncontrolled proliferation of cancer cells in the liver. The researchers led by Prof. Michael N. Hall from the Biozentrum, University of Basel, report in “Nature” that LHPP can also serve as a biomarker for the diagnosis and prognosis of liver cancer.

The incidence of liver cancer, also known as hepatocellular carcinoma, is steadily increasing. In the last twenty years, the number of cases has almost doubled...

Im Focus: Researchers at Fraunhofer monitor re-entry of Chinese space station Tiangong-1

In just a few weeks from now, the Chinese space station Tiangong-1 will re-enter the Earth's atmosphere where it will to a large extent burn up. It is possible that some debris will reach the Earth's surface. Tiangong-1 is orbiting the Earth uncontrolled at a speed of approx. 29,000 km/h.Currently the prognosis relating to the time of impact currently lies within a window of several days. The scientists at Fraunhofer FHR have already been monitoring Tiangong-1 for a number of weeks with their TIRA system, one of the most powerful space observation radars in the world, with a view to supporting the German Space Situational Awareness Center and the ESA with their re-entry forecasts.

Following the loss of radio contact with Tiangong-1 in 2016 and due to the low orbital height, it is now inevitable that the Chinese space station will...

Im Focus: Alliance „OLED Licht Forum“ – Key partner for OLED lighting solutions

Fraunhofer Institute for Organic Electronics, Electron Beam and Plasma Technology FEP, provider of research and development services for OLED lighting solutions, announces the founding of the “OLED Licht Forum” and presents latest OLED design and lighting solutions during light+building, from March 18th – 23rd, 2018 in Frankfurt a.M./Germany, at booth no. F91 in Hall 4.0.

They are united in their passion for OLED (organic light emitting diodes) lighting with all of its unique facets and application possibilities. Thus experts in...

Im Focus: Mars' oceans formed early, possibly aided by massive volcanic eruptions

Oceans formed before Tharsis and evolved together, shaping climate history of Mars

A new scenario seeking to explain how Mars' putative oceans came and went over the last 4 billion years implies that the oceans formed several hundred million...

All Focus news of the innovation-report >>>



Industry & Economy
Event News

New solar solutions for sustainable buildings and cities

23.03.2018 | Event News

Virtual reality conference comes to Reutlingen

19.03.2018 | Event News

Ultrafast Wireless and Chip Design at the DATE Conference in Dresden

16.03.2018 | Event News

Latest News

For graphite pellets, just add elbow grease

23.03.2018 | Materials Sciences

Unique communication strategy discovered in stem cell pathway controlling plant growth

23.03.2018 | Agricultural and Forestry Science

Sharpening the X-ray view of the nanocosm

23.03.2018 | Physics and Astronomy

Science & Research
Overview of more VideoLinks >>>