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Carotid Artery Stenting Using a Double-layer Micromesh Stent.

Kiyofumi Yamada1,2, Shinichi Yoshimura2, Kazumichi Yoshida1

  • 1Department of Neurosurgery, Kyoto University, Kyoto, Kyoto, Japan.

Journal of Neuroendovascular Therapy
|July 28, 2023
PubMed
Summary

Carotid artery stenting (CAS) using a novel micromesh stent shows promise in reducing ischemic complications like distal embolism. Further long-term studies are needed to confirm its safety and efficacy.

Keywords:
carotid artery stenosiscarotid artery stentingdouble-layer micromesh stentplaque protrusionstroke

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Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology
  • Biomedical Engineering

Background:

  • Carotid artery stenting (CAS) is an alternative to carotid endarterectomy (CEA), but carries a higher risk of ischemic complications.
  • Plaque protrusion (PP) through stent struts is a major cause of distal embolism, particularly with unstable plaques.
  • A double-layer micromesh stent has been developed to enhance plaque coverage and minimize PP.

Purpose of the Study:

  • To evaluate the effectiveness of a double-layer micromesh stent system for carotid artery stenting (CAS).
  • To assess the potential of this novel stent to reduce distal embolism during CAS procedures.
  • To review the clinical outcomes and applicability of micromesh stents in CAS.

Main Methods:

  • Review of clinical studies and trials evaluating the double-layer micromesh stent system for CAS.
  • Analysis of data regarding the incidence of ischemic complications, specifically distal embolism.
  • Comparison of micromesh stent outcomes with traditional CAS and CEA.

Main Results:

  • The double-layer micromesh stent system demonstrates potential in minimizing distal embolism during and after CAS, even in patients with unstable plaques.
  • Clinical trials in Japan have been completed, and the stent is in clinical use in Europe with favorable short- to medium-term results.
  • The micromesh stent may not be suitable for emergency CAS at this time.

Conclusions:

  • CAS with the double-layer micromesh stent offers a promising approach to reduce embolic complications.
  • Further long-term follow-up studies are necessary to fully establish the safety and efficacy profile of this technology.
  • The micromesh stent system represents a significant advancement in reducing risks associated with carotid artery stenting.