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Title: Carotid Artery Stenting in Acute Stroke Using a Microporous Stent Device: A Single-Center Experience.
Authors: Lamanna, Anthony;Maingard, Julian T;Kok, Hong Kuan;Barras, Christen;Jhamb, Ashu;Thijs, Vincent N;Chandra, Ronil;Brooks, Duncan Mark;Asadi, Hamed
Affiliation: Interventional Radiology Service, Department of Radiology, Austin Health, Heidelberg, Victoria, Australia
School of Medicine-Faculty of Health, Deakin University, Waurn Ponds, Australia
Department of Radiology, St. Vincent's Hospital, Melbourne, Australia
Interventional Radiology Service, Northern Hospital Radiology, Melbourne, Australia
Interventional Neuroradiology Service, Department of Radiology, Austin Health, Heidelberg, Victoria, Australia
Department of Imaging, Monash Health, Melbourne, Australia
Interventional Neuroradiology Unit-Monash Imaging, Monash Health, Melbourne, Australia
Stroke Division, The Florey Institute of Neuroscience & Mental Health, University of Melbourne, Melbourne, Australia
The University of Melbourne, Melbourne, Australia
Department of Neurology, Austin Health, Heidelberg, Victoria, Australia
South Australian Health and Medical Research Institute, Adelaide, Australia
The University of Adelaide, Adelaide, Australia
Issue Date: Jul-2019
EDate: 2019-04-08
Citation: World neurosurgery 2019; 127: e1003-e1012
Abstract: Carotid artery stenting (CAS) is an established treatment for carotid artery stenosis, typically in a semielective 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-center 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, California, USA) at a tertiary level 24-hour endovascular thrombectomy service over a 2-year period (June 2016-June 2018) were retrospectively obtained and reviewed. Twenty eCAS procedures were performed in 19 patients over the study period. Most patients had tandem lesions (12/20; 60%). Median National Institute of Health Stroke Scale score on admission was 17 (interquartile range 9-22). Stent deployment was technically successful in all patients. Recanalization rate was 95%. Symptomatic intracranial hemorrhage occurred in 2 patients (10%), both resulting in death. No other procedure-related deaths occurred. Stent thrombosis occurred in 2 patients. One delayed embolic stroke occurred. No other stent-related complications occurred. Median National Institute of Health Stroke Scale score at 24 hours postprocedure was 3 (interquartile range 1-12). Six patients had a good clinical outcome (modified Rankin Scale score between 0 and 2) at 3- to 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: 0000-0003-0705-2252
PubMed URL: 30974278
Type: Journal Article
Subjects: Carotid artery atherosclerosis
Carotid artery stenosis
Carotid artery stenting
Casper stent
Appears in Collections:Journal articles

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