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Stenting with dual-layer CGuard stent in acute sub-occlusive carotid artery stenosis and in tandem occlusions: a monocentric study

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Název: Stenting with dual-layer CGuard stent in acute sub-occlusive carotid artery stenosis and in tandem occlusions: a monocentric study
Autoři: Mousa Zidan, Christian Gronemann, Nils Christian Lehnen, Felix Bode, Johannes Weller, Gabor Petzold, Alexander Radbruch, Daniel Paech, Franziska Dorn
Zdroj: Neuroradiology
Informace o vydavateli: Springer Science and Business Media LLC, 2024.
Rok vydání: 2024
Témata: Male, Aged, 80 and over, Interventional Neuroradiology, Carotid Stenosis/surgery [MeSH], Female [MeSH], Aged, 80 and over [MeSH], Stents [MeSH], Aged [MeSH], Thrombectomy/methods [MeSH], Humans [MeSH], Retrospective Studies [MeSH], Middle Aged [MeSH], In-stent occlusion, Carotid Stenosis/diagnostic imaging [MeSH], Carotid artery stenting, Male [MeSH], Thrombectomy, Tandem occlusion, Dual-layer stent, Prosthesis Design [MeSH], Middle Aged, Prosthesis Design, 03 medical and health sciences, 0302 clinical medicine, Humans, Female, Carotid Stenosis, Stents, Aged, Retrospective Studies
Popis: Purpose Double-layer design carotid stents have been cast in a negative light since several investigations reported high rates of in-stent occlusions, at least in the acute setting of tandem occlusions. CGuard is a new generation double-layered stent that was designed to prevent periinterventional embolic events. The aim of this study was to analyze the safety and efficacy of the CGuard in emergent CAS and for the acute treatment of tandem occlusions in comparison with the single-layer Carotid Wallstent (CWS) system. Methods All patients who underwent CAS with CGuard or CWS after intracranial mechanical thrombectomy (MT) between 11/2018 and 12/2022 were identified from our local thrombectomy registry. Clinical, interventional and neuroimaging data were analyzed. Patency of the stent was assessed within 72 h. Intracranial hemorrhage and modified Rankin score (mRS) at discharge were the main endpoints. Results In total, 86 stent procedures in 86 patients were included (CWS: 44, CGuard: 42). CGuard had a lower, but not statistically significant rate (p = 0.431) of in-stent occlusions (n = 2, 4.8%) when compared to the CWS (n = 4, 9.1%). Significant in-stent stenosis was found in one case in each group. There was no statistically significant difference in functional outcome at discharge between the two groups with a median mRS for CGuard of 2 (IQR:1–5) vs. CWS 3 (IQR:2–4). Conclusion In our series, the rate of in-stent occlusions after emergent CAS was lower with the dual-layer CGuard when compared to the monolayer CWS. Further data are needed to evaluate the potential benefit of the design in more detail.
Druh dokumentu: Article
Other literature type
Jazyk: English
ISSN: 1432-1920
0028-3940
DOI: 10.1007/s00234-024-03397-w
Přístupová URL adresa: https://pubmed.ncbi.nlm.nih.gov/38844697
https://repository.publisso.de/resource/frl:6509087
Rights: CC BY
Přístupové číslo: edsair.doi.dedup.....81cbc03aeb43dc8d4383dafd2dbb0f2e
Databáze: OpenAIRE
Popis
Abstrakt:Purpose Double-layer design carotid stents have been cast in a negative light since several investigations reported high rates of in-stent occlusions, at least in the acute setting of tandem occlusions. CGuard is a new generation double-layered stent that was designed to prevent periinterventional embolic events. The aim of this study was to analyze the safety and efficacy of the CGuard in emergent CAS and for the acute treatment of tandem occlusions in comparison with the single-layer Carotid Wallstent (CWS) system. Methods All patients who underwent CAS with CGuard or CWS after intracranial mechanical thrombectomy (MT) between 11/2018 and 12/2022 were identified from our local thrombectomy registry. Clinical, interventional and neuroimaging data were analyzed. Patency of the stent was assessed within 72 h. Intracranial hemorrhage and modified Rankin score (mRS) at discharge were the main endpoints. Results In total, 86 stent procedures in 86 patients were included (CWS: 44, CGuard: 42). CGuard had a lower, but not statistically significant rate (p = 0.431) of in-stent occlusions (n = 2, 4.8%) when compared to the CWS (n = 4, 9.1%). Significant in-stent stenosis was found in one case in each group. There was no statistically significant difference in functional outcome at discharge between the two groups with a median mRS for CGuard of 2 (IQR:1–5) vs. CWS 3 (IQR:2–4). Conclusion In our series, the rate of in-stent occlusions after emergent CAS was lower with the dual-layer CGuard when compared to the monolayer CWS. Further data are needed to evaluate the potential benefit of the design in more detail.
ISSN:14321920
00283940
DOI:10.1007/s00234-024-03397-w