Casper vs. Closed-Cell Stent

• Published in: Clinical neuroradiology (Munich) Vol. 31; no. 3; pp. 843 - 852
• Main Authors: Vanzin, José Ricardo, de Castro-Afonso, Luís Henrique, Santos, Moema Nene, Manzato, Luciano Bambini, Nakiri, Guilherme Seizem, Monsignore, Lucas Moretti, Trivelato, Felipe Padovani
• Format: Journal Article
• Language: English
• Published: Heidelberg Springer 01.09.2021; Springer Nature B.V
• Subjects: Angioplasty; Asymptomatic; Brain damage; Carotid arteries; Clopidogrel; Embolization; Heart attack; Heart attacks; Ischemia; Magnetic resonance imaging; Patients; Stent (Surgery); Stents; Stroke; Stroke (Disease); Transient ischemic attack; Veins & arteries; Web sites
• ISSN: 1869-1439; 1869-1447
• DOI: 10.1007/s00062-020-00937-8

Objective The aim of this trial was to compare the efficacy of closed-cell stents with Casper stents during carotid angioplasty stenting (CAS). Methods This was a randomized superiority trial in which 88 patients were enrolled. The primary end points were the incidence, number, and size of new ischemic brain lesions after CAS under distal embolic protection devices (EPD). The secondary end points included stroke, transient ischemic attack (TIA) and myocardial infarction (MI). Ischemic brain lesions were assessed by a diffusion-weighted magnetic resonance image (DW-MRI). Neurological outcomes were evaluated by means of the National Institutes of Health scale score (NIHSS) and the modified Rankin scale (mRS). Results Compared with closed-cell stents (nâ¯= 47), Casper stents (nâ¯= 41), resulted in no significant reduction in the incidence (44.7% versus 39%, Pâ¯= 0.592), number (1.3⯱ 1.8 versus 0.9⯱ 1.5, pâ¯= 0.444), and size (3.9⯱ 5.8 mm versus 2.8⯱ 4.1â¯mm, pâ¯= 0.353) of new ischemic brain lesions. The global rate of stroke/TIA/MI was (2/88, 2.3%). Two TIA occurred during the hospitalization period, one in each group (1/41, 2.4% vs 1/47, 2.1%). One patient of the Casper group had an asymptomatic in-stent thrombosis. One patient of the control group had a MI (1/47, 2.1%) after discharge. Conclusion The Casper stents did not show superiority in the rate of incidence, number and size of new silent ischemic brain lesions detect by DW-MRI when compared to close cell stents during CAS under distal EPD.