| Autor: |
Ichiro Nakagawa, Masashi Kotsugi, Shohei Yokoyama, Ryosuke Maeoka, Takanori Furuta, Haku Tanaka, Yasuhiro Takeshima, Ryosuke Matsuda, Shuichi Yamada, Hiroyuki Nakase |
| Předmět: |
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| Zdroj: |
Journal of NeuroInterventional Surgery; Jan2024, Vol. 16 Issue 1, p67-72, 8p |
| Abstrakt: |
Background Periprocedural lipid core plaque (LCP) has been detected in carotid arteries assessed by catheterbased near-infrared spectroscopy (NIRS). High LCP is associated with cerebral embolism after carotid artery stenting (CAS) using a first-generation stent. We aimed to evaluate whether dual-layered stents reduce embolic infarcts in patients with high LCP and change of lipid signal as assessed by NIRS during CAS. Methods Participants comprised 210 consecutive patients undergoing CAS. The study was divided into two distinct periods, with first-generation closed-cell stents used in the earlier period and dual-layered stents used in the later period. NIRS was performed at baseline, after stent implantation, and after balloon post-dilatation to analyze maximal lipid core burden index at minimal luminal area (max-LCBIMLA). Results The ipsilateral cerebral embolism rate was significantly lower with dual-layered stents (9%) than with first-generation stents (33%, p<0.001), particularly with highly lipidic lesions (12% vs 60%, p<0.001). On multivariate logistic regression analysis, high LCP and first-generation stent usage were factors related to ipsilateral cerebral embolism (both p<0.001; OR 8.28 (95% CI 3.49 to 19.64) and OR 8.07 (95% CI 2.33 to 27.93), respectively). Max-LCBIMLA decreased significantly after stenting in both groups (both p<0.01) and max-LCBIMLA after balloon post-dilatation was significantly lower with dual-layered stents (22.4±65.6) than with first-generation stents (124.2±208.2; p=0.006). Conclusions Dual-layered stents reduce embolic infarcts in patients with highly lipidic plaque lesions as assessed by NIRS who undergo CAS. Dual-layered stents significantly reduced NIRS-derived lipid signals after stenting. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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