Dual-layered stents reduce cerebral embolism compared with first-generation stents during carotid stenting of high lipid core plaque lesions
| Autor: | Ichiro Nakagawa, Masashi Kotsugi, Shohei Yokoyama, Ryosuke Maeoka, Takanori Furuta, Haku Tanaka, Yasuhiro Takeshima, Ryosuke Matsuda, Shuichi Yamada, Hiroyuki Nakase |
|---|---|
| Rok vydání: | 2023 |
| Předmět: | |
| Zdroj: | Journal of NeuroInterventional Surgery. :jnis-2023 |
| ISSN: | 1759-8486 1759-8478 |
| Popis: | BackgroundPeriprocedural lipid core plaque (LCP) has been detected in carotid arteries assessed by catheter-based 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.MethodsParticipants 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).ResultsThe ipsilateral cerebral embolism rate was significantly lower with dual-layered stents (9%) than with first-generation stents (33%, pMLAdecreased significantly after stenting in both groups (both pMLAafter 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).ConclusionsDual-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. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|