Potential of new generation double-layer micromesh stent for carotid artery stenting in patients with unstable plaque ∼ A preliminary result using OFDI analysis ∼.

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Potential of new generation double-layer micromesh stent for carotid artery stenting in patients with unstable plaque ∼ A preliminary result using OFDI analysis ∼.

World Neurosurg. 2017 Jun 06;:

Authors: Yamada K, Yoshimura S, Miura M, Kanamaru T, Shindo S, Uchida K, Shirakawa M, Shibuya M, Imanaka T, Ishihara M, Masuyama T, Ishikura R, Kawasaki M

Abstract
BACKGROUND: One of the disadvantages of carotid artery stenting (CAS) is high incidence of distal embolism (DE) during or after the procedure. It has been reported that unstable plaque cases are at high risk of DE and plaque protrusion (PP) after stent placement which will become a cause of post procedural ischemic complications.
OBJECTIVE: The purpose of this study was to compare the rate and size of PP between CASPER stent which is a new generation double-layer micromesh stent and conventional stents detected by optical frequency domain imaging (OFDI) and to evaluate the efficacy of CAS with CASPER stent for cases with unstable plaque.
METHODS: Forty-six consecutive patients with unstable plaque defined as magnetic resonance imaging undergoing CAS with OFDI image acquisition were enrolled in this study. Cross-sectional OFDI images within the stented segments were evaluated at 0.125mm intervals and compared the rate and size of PP between CASPER stent and conventional stents.
RESULTS: CASPER stent was used in 9 patients. No procedural complications occurred. With OFDI analysis, presence of PP was apparently lower in CASPER stent group than conventional stents group (44% vs 88%, p=0.022). Also, mean PP area was significantly smaller in CASPER stent group than conventional stents group (Mean PP area: 0.013 ± 0.034 mm(2) vs 0.057 ± 0.09 mm(2), p=0.006).
CONCLUSION: Using OFDI evaluation after CAS, the degree of PP was significantly smaller in CASPER stent than conventional stents. This result indicates new insights of CAS for the treatment of carotid artery stenosis with unstable plaque.

PMID: 28599905 [PubMed - as supplied by publisher]

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