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Updated: Dec 13, 2025
A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
Casper vs. Closed-Cell Stent : Carotid Artery Stenting Randomized Trial
José Ricardo Vanzin1,2, Luís Henrique de Castro-Afonso3, Moema Nene Santos4
1Division of Interventional Neuroradiology, Medical School of Passo Fundo, Federal University of South Frontier, Rua Teixeira Soares, 640, Centro, 99080-020, Passo Fundo, RS, Brazil. jrvanzin@gmail.com.
Casper stents did not demonstrate superiority over closed-cell stents in reducing new ischemic brain lesions during carotid angioplasty with distal embolic protection. Both stent types showed similar safety profiles regarding stroke and myocardial infarction rates.
Area of Science:
- Interventional Cardiology
- Neurology
- Medical Device Technology
Background:
- Carotid angioplasty stenting (CAS) is a common procedure for treating carotid artery stenosis.
- Embolic protection devices (EPDs) are used to minimize the risk of cerebral ischemia during CAS.
- Different stent designs, such as closed-cell and Casper stents, may influence procedural outcomes.
Purpose of the Study:
- To compare the efficacy of Casper stents versus closed-cell stents in CAS procedures.
- To evaluate the impact of stent design on the occurrence, number, and size of new ischemic brain lesions.
- To assess secondary clinical outcomes including stroke, transient ischemic attack (TIA), and myocardial infarction (MI).
Main Methods:
- A randomized superiority trial involving 88 patients undergoing CAS with distal EPD.
- Patients were assigned to either closed-cell stents (n=47) or Casper stents (n=41).
- Diffusion-weighted magnetic resonance imaging (DW-MRI) was used to assess new ischemic brain lesions; neurological outcomes were evaluated using NIHSS and mRS.
Main Results:
- No significant difference was observed in the incidence (44.7% vs 39%), number (1.3±1.8 vs 0.9±1.5), or size (3.9±5.8 mm vs 2.8±4.1 mm) of new ischemic brain lesions between Casper and closed-cell stents.
- The overall rate of stroke/TIA/MI was low (2.3%), with one TIA occurring in each group.
- One asymptomatic in-stent thrombosis was noted in the Casper group, and one MI occurred post-discharge in the closed-cell stent group.
Conclusions:
- Casper stents did not prove superior to closed-cell stents in reducing the incidence, number, or size of new silent ischemic brain lesions detected by DW-MRI during CAS with distal EPD.
- Both stent types demonstrated comparable safety profiles in this trial.
- Further research may explore other potential differences or specific patient subgroups where one stent design might offer advantages.
