Técnica para quantificação e qualificação de material coletado em filtros de proteção cerebral Technique for quantifying and qualifying debris captured in embolic protection filters

Background: Quality and quantity of the content retained in em- bolic protection filters (EPFs) used in percutaneous transluminal angio- plasty and stenting may possibly indicate the importance of EPFs in the management of carotid stenosis. Objectives: To analyze the content retained by EPFs in patients undergoing percutaneous transluminal angioplasty and stenting of the in- ternal carotid artery using a new technique for qualitative and quantita- tive analysis. Methods: Material captured in 10 EPFs during percutaneous trans- luminal angioplasty and stenting in high-surgical-risk patients was exam- ined to determine a qualitative and quantitative microscopic analysis. Digital photographs of the hematoxylin-eosin stained slides were ana- lyzed using the Axio Vision LE Release 4.1 software in order to calculate the particles area in micra/square meter (m 2 ). Results: Histopathological examination identified particulate de- bris in 100% of the filters including predominantly blood residues, cho- lesterol crystals, and calcium Quantity of captured fragments was significant (mean of 1,570,310 m 2 ) with a wide range of these values. Conclusions: Significant quantity of fragments of atheromatous plaques is retained by EPFs and the wide range in the quantity of the re- tained debris can be associated with the lesion severity; therefore new studies using standardized technique for quantifying these fragments and for better understanding their real clinical meaning are necessary.