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Case Studies| Volume 25, ISSUE 3, e31-e32, March 2016

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Three-Dimensional Optical Frequency Domain Imaging Evaluation of Novel Dual-Layered Carotid Stent Implantation for Vulnerable Carotid Plaque

      Plaque prolapse through the cell stent has been suggested as one of the major causes of postprocedural distal embolization after carotid artery stenting. A CASPER stent (Terumo, Tokyo, Japan) is the latest-generation stent having the dual layers and expected to reduce the risk of embolization. A 76-year-old male asymptomatic patient with high-grade stenosis in the left internal carotid artery received carotid artery stenting. Preoperative magnetic resonance imaging demonstrated very high intensity signals on T1-weighted images. After a predilatation, a CASPER stent, which has a dual-layer design construction with an inner nitinol micromesh woven onto an external closed-cell stent, was deployed followed by postdilatation. Postprocedural optical frequency domain imaging revealed good apposition of the outer stent to the vascular wall and no significant prolapse of plaque materials between the struts of the inner micromesh. No ischemic lesions were identified on MRI and no abnormal neurological findings were noted after stenting.

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      References

        • Aikawa H.
        • Kodama T.
        • Nii K.
        • et al.
        Intraprocedural plaque protrusion resulting in cerebral embolism during carotid angioplasty with stenting.
        Radiat Med. 2008; 26: 318-323
        • Takigawa T.
        • Matsumaru Y.
        • Kubo T.
        • et al.
        Recurrent subacute in-stent restenosis after carotid artery stenting due to plaque protrusion.
        Neurol Med Chir (Tokyo). 2009; 49: 413-417
        • Ferroro E.
        • Ferri M.
        • Viazzo A.
        • et al.
        Carotid stent removal of symptomatic plaque protrusion after carotid angioplasty stenting.
        Interact Cardiovasc Thorac Surg. 2010; 11: 254-256
        • Hopf-Jensen S.
        • Marques L.
        • Preiß M.
        • et al.
        Initial clinical experience with the micromesh roadsaver carotid artery stent for the treatment of patients with symptomatic carotid artery disease.
        J Endovasc Ther. 2015; 22: 220-225
        • Yamada K.
        • Yoshimura S.
        • Kawasaki M.
        • et al.
        Embolic complications after carotid artery stenting or carotid endarterectomy are associated with tissue characteristics of carotid plaques evaluated by magnetic resonance imaging.
        Atherosclerosis. 2011; 215: 399-404
        • Tanemura H.
        • Maeda M.
        • Ichikawa N.
        • et al.
        High-risk plaque for carotid artery stenting evaluated with 3-dimensional T1-weighted gradient echo sequence.
        Stroke. 2013; 44: 105-110
        • Brott T.G.
        • Hobson Jr, R.W.
        • Haward G.
        • et al.
        Stenting versus endarterectomy for treatment of carotid-artery stenosis.
        N Engl J Med. 2010; 363: 11-23
        • Bosiers M.
        • de Donato G.
        • Deloose K.
        • et al.
        Does free cell area influence the outcome in carotid artery stenting?.
        Eur J Vasc Endovasc Surg. 2007; 33: 135-141