Evaluating the effectiveness and safety of the carotid Casper-RX stent for tandem lesions in acute ischemic stroke.

Détails

ID Serval
serval:BIB_9CE311972F36
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Evaluating the effectiveness and safety of the carotid Casper-RX stent for tandem lesions in acute ischemic stroke.
Périodique
Journal of neurointerventional surgery
Auteur(s)
Bartolini B., Puccinelli F., Mosimann P.J., Hajdu S.D., Veunac L., Michel P., Saliou G.
ISSN
1759-8486 (Electronic)
ISSN-L
1759-8478
Statut éditorial
Publié
Date de publication
08/2019
Peer-reviewed
Oui
Volume
11
Numéro
8
Pages
772-774
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
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).
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.
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.
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.
Mots-clé
cervical, stent, stroke
Pubmed
Création de la notice
13/12/2018 17:03
Dernière modification de la notice
21/08/2019 6:33
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