Stent-protected carotid angioplasty using a membrane stent: a comparative cadaver study

Area of Science:

• Biomedical Engineering
• Vascular Surgery
• Medical Devices

Background:

• Carotid artery stenting is a common procedure to prevent stroke.
• Embolization during stenting can lead to neurological complications.
• Novel devices aim to reduce embolic events.

Purpose of the Study:

• To assess the performance of the MembraX membrane stent in preventing acute and late embolization.
• To quantify particle embolization during carotid stent placement using human carotid explants.
• To compare the MembraX stent with a bare stent and a bare stent with an embolic protection device.

Main Methods:

• Thirty human carotid cadaveric explants were used in a pulsatile-flow model.
• Explants were randomized into three groups: MembraX stent, Xpert bare stent, and Xpert bare stent with Emboshield protection device.
• Emboli were measured in 100-micrometer filters during stent deployment, post-dilatation, and simulated late embolization.

Main Results:

• No statistically significant differences in embolic load were found between the MembraX stent and the bare stent.
• The Emboshield protection device resulted in a higher embolic load by weight and particle number compared to the bare stent.
• The MembraX stent showed a trend towards reduced particles during simulated late embolization.

Conclusions:

• Neither the MembraX membrane stent nor the Emboshield protection device demonstrated significant advantages in preventing emboli during ex vivo carotid angioplasty.
• The MembraX stent may have potential in reducing particles associated with late embolization.
• Further research is warranted to validate these findings and explore the role of embolic protection devices.