Evaluating the effectiveness and safety of the carotid Casper-RX stent for tandem lesions in acute ischemic stroke.
J Neurointerv Surg
; 11(8): 772-774, 2019 Aug.
Article
em En
| MEDLINE
| ID: mdl-30514733
ABSTRACT
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.Palavras-chave
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Bases de dados:
MEDLINE
Assunto principal:
Artéria Carótida Interna
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Isquemia Encefálica
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Estenose das Carótidas
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Acidente Vascular Cerebral
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Stents Metálicos Autoexpansíveis
Tipo de estudo:
Evaluation_studies
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Observational_studies
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Risk_factors_studies
Limite:
Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Neurointerv Surg
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Suíça