What should be the Optimal Carotid Stent Opening Rate Without Post-Dilation?

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Medical Device Technology

Background:

• Optimal stent expansion rates for carotid artery stenting (CAS) remain debated.
• This study investigates the impact of varying carotid stent opening rates (CSOR) without post-dilation on patient outcomes.

Purpose of the Study:

• To evaluate the efficacy and safety of achieving a CSOR of at least 50% without post-dilation in CAS.
• To compare in-hospital and long-term clinical outcomes between different CSOR groups.

Main Methods:

• A cohort of 825 patients undergoing CAS without post-dilation was analyzed.
• Patients were stratified into two groups based on final CSOR: 50-79% and 80-100%.
• In-hospital and 3-year outcomes were compared between the two groups.

Main Results:

• No significant differences were observed in in-hospital ipsilateral stroke, major stroke, or transient ischemic attacks between the CSOR groups.
• Three-year Kaplan-Meier survival rates were comparable (87.6% vs. 84.4%).
• Three-year cumulative ipsilateral stroke rates were also similar (88.0% vs. 88.6%).

Conclusions:

• Achieving a CSOR above 50% without post-dilation appears to be an effective strategy in CAS.
• The findings suggest that post-stent balloon dilation may be unnecessary, potentially due to adequate stent self-expansion.