Optical coherence tomography assessment of newgeneration mesh-covered stents after carotid stenting

EuroIntervention. 2017 Dec 20;13(11):1347-1354. doi: 10.4244/EIJ-D-16-00866.

Abstract

Aims: The aim of this study was to identify the findings (by optical coherence tomography [OCT]) after carotid artery stenting (CAS) with two different types of new-generation mesh-covered stent.

Methods and results: Sixteen consecutive patients undergoing CAS with mesh-covered stents and highdefinition OCT image acquisition were enrolled in the study. Cross-sectional OCT images for the presence of strut malapposition (SM) and plaque prolapse (PP) were evaluated using a proximal or distal embolic protection device (EPD). CGuard stents were used in 11 patients (68.8%) and RoadSaver stents in five (31.2%). With OCT analysis, the incidence of SM was 20.5% for CGuard vs. 26.8% for RoadSaver, p=0.26, and the incidence of PP was 10.8% for CGuard vs. 20.7% for RoadSaver, p=0.05. No neurological complications (stroke/TIA) occurred during the procedural and post-procedural periods.

Conclusions: The OCT findings of two different types of mesh-covered stent after CAS were obtained safely. Our work indicates that current mesh-covered carotid stents may show differences in SM and PP. The effect of stent design and implantation technique on OCT findings post CAS, and their relation to longterm clinical outcomes, require further evaluation.

Publication types

  • Comparative Study
  • Multicenter Study
  • Observational Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Carotid Stenosis / diagnostic imaging
  • Carotid Stenosis / therapy*
  • Coronary Vessels / diagnostic imaging*
  • Embolic Protection Devices
  • Endovascular Procedures / adverse effects
  • Endovascular Procedures / instrumentation*
  • Female
  • Humans
  • Italy
  • Male
  • Predictive Value of Tests
  • Prospective Studies
  • Prosthesis Design
  • Stents*
  • Time Factors
  • Tomography, Optical Coherence*
  • Treatment Outcome