Decoding Carotid Stent Design_ A Deep Dive into Embolization Risk
Episode notes
This study aimed to evaluate the influence of carotid stent design on the risk of embolization during carotid artery stenting. Specifically, the research contrasted the volume of embolized material caught by filters during the procedure, using stents of different designs, namely, open-cell stents (OCS), closed-cell stents (CCS), and micromesh stents (MMS). The study was retrospective and conducted on patients with asymptomatic carotid stenosis above 70%, who underwent carotid artery stenting in an Italian medical institution between 2010 and 2022. The main focus, or primary end point, was the ratio of particulate material-to-total filter area, known as the embolic filter debris (EFD) load. The secondary endpoints studied were 30-day major stroke and death rates. Results from 481 carotid artery stentings revealed that 35% used OCS, 14% used CCS, and 50% used MMS. The 30-day mortality and major stroke rate was low at 0.2%. Interestingly, the use of MMS resulted in the cleanest filters (41% free from embolized material), and had a lower EFD load compared to other stent designs. These findings remained consistent even after adjusting for plaque characteristics. In conclusion, micromesh stents seemed to be associated with a lessened embolization risk during carotid artery stenting, as evidenced by lower embolic filter debris load and more filters free from particulate matter. Nevertheless, further studies will be necessary to confirm these findings and potentially guide the choice of stent design in clinical practice. https://www.ahajournals.org/doi/10.1161/STROKEAHA.123.043117?fbclid=IwAR25o0dKZYcQ3jUu1QfQYF5vN4z4-1eZNy0PoDZ4kNZqDSTK5NNAs4WNcko_aem_AUsuUyz0w5Mxg2DeftDGbvclFpXMGjtUtewhrI7kK3F05PRr4TWYwArurR4uzLNbHaE