Highlights
- •CGUARD stents is feasible and safe compared to one layer stents in symptomatic and asymptomatic patients.
- •The rate of thromboembolic complications compares favorably with Wallstent for emergent, urgent and elective cases.
- •No significant differences in the rate of acute in-stent occlusions among the 3 groups.
- •No significant differences in the rate of postinterventional symptomatic intracerebral hemorrhage among the 3 groups.
Abstract
Stent protected Angioplasty of extracranial carotid artery stenosis using the dual-layered
CGUARD stent is a novel treatment option. In this study we evaluate the feasibility
and the safety of the CGUARD in symptomatic and asymptomatic patients in comparison
to Casper-RX and Wallstent. This is a multi-center study of consecutive patients treated
with the CGUARD, Casper-RX and Wallstent at two German high volume neurovascular centers
between April 2017 and May 2018. Patient characteristics, neuroimaging data and angiographic
outcome were retrospectively analyzed. The primary end points of the study were acute
occlusion of the carotid stent and symptomatic intracerebral hemorrhage (sICH). Carotid
artery stenting was performed in 76 patients; of those 26 (34%) were treated with
the CGUARD, 25 (33%) with Casper-RX, and 25 (33%) with Wallstent. In 58/76 (76%) cases
carotid artery stenosis was symptomatic with a median baseline National Institutes
of Health Stroke Scale of 4. Angioplasty and stenting as part of a mechanical thrombectomy
for acute ischemic stroke was performed in 25/76 (33%) patients. Baseline patient
characteristics were similar between the treatment groups, except for a higher portion
of scheduled cases in the Casper-RX group. There were no significant differences in
the rate of acute in stent occlusions (CGUARD, 2/26 (8%); Casper-RX, 1/25(4%); Wallstent,
1/25 (4%)) and postinterventional sICH (1/26 (4%), 0/25(0%), 0/25 (0%)). Clinical
outcome at discharge did not differ between groups. Treatment of carotid artery stenosis
using CGUARD is feasible with a good safety profile comparable to that of Casper-RX
and Wallstent.
Keywords
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Article info
Publication history
Published online: March 12, 2020
Accepted:
March 8,
2020
Received:
July 18,
2019
Identification
Copyright
© 2020 Elsevier Ltd. All rights reserved.
