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Title: Carotid artery stenting in acute stroke using a microporous stent device: a single centre experience.
Austin Authors: Lamanna, Anthony ;Maingard, Julian;Kok, Hong Kuan;Barras, Christen;Jhamb, Ashu;Thijs, Vincent N ;Chandra, Ronil;Brooks, Duncan Mark ;Asadi, Hamed 
Affiliation: The University of Melbourne, Melbourne, Australia
Interventional Neuroradiology Unit - Monash Imaging, Monash Health, Melbourne, Australia
Interventional Radiology Service, Department of Radiology, Austin Health, Heidelberg, Victoria, Australia
Department of Radiology, St Vincent's Hospital, Melbourne, Australia
Department of Neurology, Austin Health, Heidelberg, Victoria, Australia
Department of Imaging - Monash Health, Melbourne, Australia
Interventional Neuroradiology Service, Department of Radiology, Austin Health, Heidelberg, Victoria, Australia
School of Medicine - Faculty of Health, Deakin University, Waurn Ponds, Australia
South Australian Health and Medical Research Institute, Adelaide, Australia
The University of Adelaide, Adelaide, Australia
Stroke Division, The Florey Institute of Neuroscience & Mental Health, University of Melbourne, Melbourne, Australia
Department of Interventional Radiology - Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom..
Issue Date: Jul-2019 2019-04-08
Publication information: World Neurosurgery 2019; 127: e1003-e1012
Abstract: Carotid artery stenting (CAS) is an established treatment for carotid artery stenosis, typically in a semi-elective or elective setting. The growth of mechanical thrombectomy for acute stroke has led to an increased use of emergent carotid artery stenting (eCAS). This single-centre retrospective case series evaluates the safety and efficacy of eCAS using a dual-layer micromesh nitinol stent to treat carotid artery stenosis in the acute stroke setting. Ethics approval was granted by the institutional review board. Clinical data of all patients who underwent CAS using the Casper dual-layer micromesh nitinol stent system (Microvention, Terumo, Tustin, CA, USA) at a tertiary level 24-hour endovascular thrombectomy service over a two-year period (June 2016-June 2018) were retrospectively obtained and reviewed. Twenty eCAS procedures were performed in nineteen patients over the study period. Most patients had tandem lesions (12/20; 60%). Median NIHSS score on admission was 17 (IQR 9-22). Stent deployment was technically successful in all patients. Recanalization rate was 95%. Symptomatic intracranial haemorrhage occurred in two patients (10%), both resulting in death. No other procedure-related deaths occurred. Stent thrombosis occurred in two patients. One delayed embolic stroke occurred. No other stent-related complications occurred. Median NIHSS score at 24 hours postprocedure was 3 (IQR 1-12). Six patients had a good clinical outcome (modified Rankin scale between 0-2) at 3-6 month follow up (38%). eCAS using the Casper stenting system is effective and technically feasible in the acute stroke setting, although the ideal antiplatelet and anticoagulation regime is not clearly established.
DOI: 10.1016/j.wneu.2019.04.024
ORCID: 0000-0001-8958-2411
PubMed URL: 30974278
Type: Journal Article
Subjects: Casper stent
carotid artery atherosclerosis
carotid artery stenosis
carotid artery stenting
Appears in Collections:Journal articles

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