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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Published online: December 24, 2015
Accepted: November 14, 2015
Received in revised form: November 11, 2015
Received: September 24, 2015
© 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.