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The problem with evidence is that it doesnt always agree with your facts. —Stephen Colbert Distal protection devices appear seductively simple, elegant, and beneficial to both physicians and patients. Why would you not want to use something called "distal protection?" To not use "distal protection" during carotid angioplasty and stent placement (CAS) sounds irresponsible, like not practicing "safe sex." In a simple world, distal protection devices would do exactly what their name implies, that is, eliminate complications of CAS that are caused by distal emboli. But we do not live in such a simple world. Every medical device has both benefits and risks. To properly characterize the risk-benefit profile of a device, controlled studies are needed, comparing patients treated with the device to patients not treated with the device. That sounds like simple, high school science. But no such study exists. Instead we have retrospective data comparing patients treated before and treated after the introduction of distal protection devices, such as the article in this issue of American Journal of Neuroradiology by Kastrup et al. 1 These authors report that the proportion of patients with new ipsilateral diffusion-weighted imaging (DWI) lesions was significantly lower (52% versus 65%) after
American Journal of Neuroradiology – American Journal of Neuroradiology
Published: Mar 1, 2008
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