Evaluating the effectiveness and safety of the carotid Casper-RX stent for tandem lesions in acute ischemic stroke.
| Autor: | Bartolini, Bruno, Puccinelli, Francesco, Mosimann, Pascal J., Hajdu, Steven D., Veunac, Louis, Michel, Patrik, Saliou, Guillaume |
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| Předmět: |
CAROTID artery radiography
ANGIOPLASTY ANTICOAGULANTS ENDOVASCULAR surgery CEREBRAL angiography CEREBRAL hemorrhage CEREBRAL embolism & thrombosis CEREBRAL ischemia REPORTING of diseases HEMODYNAMICS INTRAVENOUS therapy NEURORADIOLOGY SURGICAL stents STROKE TERMINATION of treatment CAROTID artery stenosis DISCHARGE planning TREATMENT effectiveness RETROSPECTIVE studies ACUTE diseases PLATELET aggregation inhibitors PERIOPERATIVE care DISEASE risk factors |
| Zdroj: | Journal of NeuroInterventional Surgery; Aug2019, Vol. 11 Issue 8, p772-774, 4p, 2 Charts |
| Abstrakt: | Introduction: A new generation of carotid artery stents that use a dual micromesh layer to reduce embolic events during carotid artery stenting has recently been introduced. We aimed to analyze the effectiveness and safety of the new Casper-RX stent in patients experiencing acute ischemic stroke with large vessel intracranial occlusion associated with a tandem lesion (another carotid occlusion or severe stenosis). Methods: We retrospectively analyzed all consecutive patients treated with carotid Casper-RX stents from our stroke registry. We analyzed clinical, angiographic, and neuroimaging data. Endpoints included acute intra-stent thrombus formation, stent occlusion prior to hospital discharge, 3 month modified Rankin Scale score (mRS), and symptomatic intracranial hemorrhage. Results: 21 patients were included: 10 patients had tandem carotid occlusions and 11 patients had severe carotid stenosis, 8 of whom had a hemodynamically significant stenosis. We observed acute in-stent thrombus formation in 11 patients. No stent occlusion occurred prior to hospital discharge. We report no stroke recurrence at 3 months but symptomatic intracranial hemorrhage in two patients. mRS score at 3 months was 0-2 (favorable) for 15 patients (71%), 3-5 for 3 patients, and 6 for 3 patients. Conclusions: In the present series, we frequently observed clot formation during the procedure with Casper-RX stents, which required periprocedural intravenous infusion of anticoagulant and antiplatelet treatment. This motivated us, in the absence of a prospective randomized controlled study demonstrating the non-inferiority of micromesh dual layer stents compared with the single layer design, to discontinue using this stent type in acute stroke requiring carotid angioplasty. [ABSTRACT FROM AUTHOR] |
| Databáze: | Complementary Index |
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