Commentary: Double-Layer Carotid Stents: From the Clinical Need,through a Stent-in-Stent Strategy,to Effective Plaque Isolation… the Journey Toward Safe Carotid Revascularization Using the Endovascular Route

Abstract

Keywords

carotid artery stenosis carotid artery stenting carotid endarterectomy closed-cell stent MicroNET open-cell stent plaque protrusion stent-graft restenosis double-layer stent unstable plaque

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References

Flach

Ouhlous

Hendriks

et al . Cerebral ischemia after carotid intervention. J Endovasc Ther. 2004;11:251-257.

Schnaudigel

Gröschel

Pilgram

et al . New brain lesions after carotid stenting versus carotid endarterectomy: a systematic review of the literature. Stroke. 2008;39:1911-1919.

Brott

Hobson

2nd Howard

et al . Stenting versus endarterectomy for treatment of carotid-artery stenosis. N Engl J Med. 2010;363:11-23.

Conrad

Boulom

Mukhopadhyay

et al . Progression of asymptomatic carotid stenosis despite optimal medical therapy. J Vasc Surg. 2013;58:128-135.

Conrad

Michalczyk

Opalacz

et al . The natural history of asymptomatic severe carotid artery stenosis. J Vasc Surg. 2014;60:1218-1226.

Kakkos

Nicolaides

Charalambous

et al . Predictors and clinical significance of progression or regression of asymptomatic carotid stenosis. J Vasc Surg. 2014;59:956-967.

Goyal

Menon

van Zwam

et al . Endovascular thrombectomy after large-vessel ischaemic stroke: A meta-analysis of individual patient data from five randomised trials. Lancet. 2016;387:1723-1731.

Spagnoli

Mauriello

Sangiorgi

et al . Extracranial thrombotically active carotid plaque as a risk factor for ischemic stroke. JAMA. 2004;292:1845-1852.

Virmani

Ladich

Burke

et al . Histopathology of carotid atherosclerotic disease. Neurosurgery. 2006;59(Suppl 3):S219-227.

10.

Mauriello

Servadei

Sangiorgi

et al . Asymptomatic carotid plaque rupture with unexpected thrombosis over a non-canonical vulnerable lesion. Atherosclerosis. 2011;218:356-362.

11.

Lal

Meschia

Brott

TG.

Clinical need, design, and goals for the Carotid Revascularization and Medical Management for Asymptomatic Carotid Stenosis trial. Semin Vasc Surg. 2017;30(1):2-7.

12.

Paul

Sturm

Dewey

et al . Long-term outcome in the North East Melbourne Stroke Incidence study: Predictors of quality of life at 5 years after stroke. Stroke. 2005;36:2082-2086.

13.

Musialek

Hopf-Jensen

Commentary: Carotid artery revascularization for stroke prevention: A new era. J Endovasc Ther. 2017;24:138-148.

14.

Musialek

Grunwald

IQ.

How asymptomatic is “asymptomatic” carotid stenosis? Resolving fundamental confusion(s) – and confusions yet to be resolved. Pol Arch Intern Med. 2017;127:718-719.

15.

Trystula

Tomaszewski

Pachalska

Health-related quality of life in ischaemic stroke survivors after carotid endarterectomy (CEA) and carotid artery stenting (CAS): Confounder-controlled analysis. Adv Interv Cardiol. Published online April 13, 2019. DOI:10.5114/aic.2019.84441

16.

Musialek

Update on results with the CGuard MicroNET covered stent for CAS: Does it cause in-stent restenosis or other long-term problems? Can it have value in other vascular beds?

Presented at: Vascular Endovascular Issues Techniques Horizons (VEITH); November 22, 2018; New York, NY, USA. https://www.veithsymposium.org/abstracts/2018/vei/823.pdf .

17.

Biasi

Froio

Diethrich

et al . Carotid plaque echolucency increases the risk of stroke in carotid stenting: The Imaging in Carotid Angioplasty and Risk of Stroke (ICAROS) study. Circulation. 2004;110:756-762.

18.

Montorsi

Caputi

Galli

et al . Microembolization during carotid artery stenting in patients with high-risk, lipid-rich plaque. A randomized trial of proximal versus distal cerebral protection. J Am Coll Cardiol. 2011;58:1656-1663.

19.

Bijuklic

Wandler

Hazizi

et al . The PROFI study (Prevention of Cerebral Embolization by Proximal Balloon Occlusion Compared to Filter Protection During Carotid Artery Stenting): A prospective randomized trial. J Am Coll Cardiol. 2012;59:1383-1389.

20.

Leal

Orgaz

Flores

et al . A diffusion-weighted magnetic resonance imaging-based study of transcervical carotid stenting with flow reversal versus transfemoral filter protection. J Vasc Surg. 2012;56:1585-1590.

21.

Bosiers

de Donato

Deloose

et al . Does free cell area influence the outcome in carotid artery stenting? Eur J Vasc Endovasc Surg. 2007;33:135-141.

22.

Stabile

de Donato

Musialek

et al . Use of dual-layered stents in endovascular treatment of extracranial stenosis of the internal carotid artery: results of a patient-based meta-analysis of 4 clinical studies. JACC Cardiovasc Interv. 2018;11:2405-2411.

23.

Pieniazek

Musialek

Kablak-Ziembicka

et al . Carotid artery stenting with patient- and lesion-tailored selection of the neuroprotection system and stent type: Early and 5-year results from a prospective academic registry of 535 consecutive procedures (TARGET-CAS). J Endovasc Ther. 2008;15:249-262.

24.

Paraskevas

Veith

Parodi

JC.

Transcervical carotid artery stenting (CAS) with flow reversal: a promising technique for the reduction of strokes associated with CAS. J Endovasc Ther. 2016;23:255-257.

25.

Fairman

Gray

Scicli

et al . The CAPTURE registry: Analysis of strokes resulting from carotid artery stenting in the post approval setting: timing, location, severity, and type. Ann Surg. 2007;246:551-556.

26.

Paraskevas

Mikhailidis

Veith

FJ.

Mechanisms to explain the poor results of carotid artery stenting (CAS) in symptomatic patients to date and options to improve CAS outcomes. J Vasc Surg. 2010;52:1367-1375.

27.

Harada

Oshikata

Kajihara

Optical coherence tomography of tissue prolapse after carotid artery stenting using closed cell design stents for unstable plaque. J Neurointervent Surg. 2018;10:229-234.

28.

Brott

Howard

Roubin

et al . Long-term results of stenting versus endarterectomy for carotid-artery stenosis. N Engl J Med. 2016;374:1021-1031.

29.

Mousa

Broce

Commentary: Carotid endarterectomy before and after CREST. J Endovasc Ther. 2016;23:536-537.

30.

Cohen

Stolker

Wang

et al . CREST Investigators. Health-related quality of life after carotid stenting versus carotid endarterectomy: results from CREST (Carotid Revascularization Endarterectomy Versus Stenting Trial). J Am Coll Cardiol. 2011;58:1557-1565.

31.

Sardar

Chatterjee

Aronow

et al . Carotid artery stenting versus endarterectomy for stroke prevention: a meta-analysis of clinical trials. J Am Coll Cardiol. 2017;69:2266-2275.

32.

Reimers

Nikas

Stabile

et al . Preliminary experience with optical coherence tomography imaging to evaluate carotid artery stents: Safety, feasibility, and techniques. EuroIntervention. 2011;7:98-105.

33.

De Donato

Setacci

Sirignano

et al . Optical coherence tomography after carotid stenting: Rate of stent malapposition, plaque prolapse and fibrous cap rupture according to stent design. Eur J Vasc Endovasc Surg. 2013;45:579-587.

34.

Liu

Jiang

Xiong

et al . An optical coherence tomography assessment of stent strut apposition based on the presence of lipid-rich plaque in the carotid artery. J Endovasc Ther. 2015;22:942-949.

35.

Shinozaki

Ogata

Ikari

Plaque protrusion detected by intravascular ultrasound during carotid artery stenting. J Stroke Cerebrovasc Dis. 2014;23:2622-2625.

36.

Yamada

Yoshimura

Miura

et al . Potential of new-generation double-layer micromesh stent for carotid artery stenting in patients with unstable plaque: a preliminary result using OFDI analysis. World Neurosurg. 2017;105:321-326.

37.

Aikawa

Kodama

Nii

et al . Intraprocedural plaque protrusion resulting in cerebral embolism during carotid angioplasty with stenting. Radiat Med. 2008;26:318-323.

38.

Kotsugi

Takayama

Myouchin

et al . Carotid artery stenting: investigation of plaque protrusion incidence and prognosis. JACC Cardiovasc Interv. 2017;10:824-831.

39.

Okazaki

Sakamoto

Shinagawa

et al . Detection of in-stent protrusion (ISP) by intravascular ultrasound during carotid stenting: Usefulness of stent-in-stent placement for ISP. Eur Radiol. 2019;29:77-84.

40.

Musialek

Hopkins

Siddiqui

AH.

One swallow does not a summer make but many swallows do: Accumulating clinical evidence for nearly-eliminated peri-procedural and 30-day complications with mesh-covered stents transforms the carotid revascularisation field. Adv Interv Cardiol. 2017;13:95-106.

41.

Vitek

Roubin

Al-Mubarek

et al . Carotid artery stenting: technical considerations. AJNR Am J Neuroradiol. 2000;21:1736-1743.

42.

Tanaka

Kitagawa

Yamana

et al . Mobility of an in-stent plaque protrusion detected with carotid duplex during the carotid artery stenting procedure. Med Ultrason. 2019;21:89-92.

43.

Stankovic

Colombo

Presbitero

et al . Randomized evaluation of polytetrafluoroethylene-covered stent in saphenous vein grafts: the Randomized Evaluation of polytetrafluoroethylene COVERed stent in Saphenous vein grafts (RECOVERS) trial. Circulation. 2003;108:37-42.

44.

Choudhury

Blackman

Channon

KM.

Distal embolisation in percutaneous saphenous vein graft intervention despite use of a polymer covered stent. Heart. 2005;91:1259.

45.

Blackman

Choudhury

Banning

et al . Failure of the Symbiot PTFE-covered stent to reduce distal embolization during percutaneous coronary intervention in saphenous vein grafts. J Invasive Cardiol. 2005;17:609-612.

46.

Ammi

Henni

Salomon

Mont

et al . Lower rate of restenosis and reinterventions with covered vs bare metal stents following innominate artery stenting. J Endovasc Ther. 2019;26(3):385-390.

47.

de Borst

. Commentary: Innominate artery stenting: the continuing saga of “who, when, and how”? J Endovasc Ther. 2019;26(3):391-393.

48.

Schillinger

Dick

Wiest

et al . Covered versus bare self-expanding stents for endovascular treatment of carotid artery stenosis: A stopped randomized trial. J Endovasc Ther. 2006;13:312-319.

49.

Szólics

Sztriha

Szikra

et al . The use of covered stents for the endovascular treatment of extracranial internal carotid artery stenosis: A prospective study with a 5-year follow-up. Eur Radiol. 2010;20:1772-1776.

50.

Myouchin

Takayama

Wada

et al . Carotid artery stenting using a closed-cell stent-in-stent technique for unstable plaque. J Endovasc Ther. 2019;26(4):565–571.

51.

Wissgott

Schmidt

Brandt

et al . Preliminary clinical results and mechanical behavior of a new double-layer carotid stent. J Endovasc Ther. 2015;22:634-639.

52.

Musialek

Kolvenbach

Schofer

. Regarding: “Acute occlusions of dual-layer carotid stents after endovascular emergency treatment of tandem lesions.” Stroke. 2017;48:e364.

53.

Schofer

Musiałek

Bijuklic

et al . A Prospective, multicenter study of a novel mesh-covered carotid stent: the CGuard CARENET trial (Carotid Embolic Protection Using MicroNet). JACC Cardiovasc Interv. 2015;8:1229-1234.

54.

Wissgott

Schmidt

Brandt-Wunderlich

et al . Clinical results and mechanical properties of the Carotid CGUARD Double-Layered Embolic Prevention Stent. J Endovasc Ther. 2017;24:130-137.

55.

Nerla

Castriota

Micari

et al . Carotid artery stenting with a new-generation double-mesh stent in three high-volume Italian centres: Clinical results of a multidisciplinary approach. EuroIntervention. 2016;12:e677-83.

56.

Umemoto

de Donato

Pacchioni

et al . Optical coherence tomography assessment of new generation mesh-covered stents after carotid stenting. EuroIntervention. 2017;13:1347-1354.

57.

Musialek

Stabile

Residual plaque prolapse with novel dual-layer carotid stents: Is it mesh-covered or not?

EuroIntervention. 2017;13:1266-1268.

58.

Mazurek

Partyka

Trystula

et al . Highly-calcific carotid lesions endovascular management in symptomatic and increased-stroke-risk asymptomatic patients using the CGuard™ dual-layer carotid stent system: Analysis from the PARADIGM study. Catheter Cardiovasc Interv. Published online April 3, 2019. doi: 10.1002/ccd.28219.

59.

Musialek

Mazurek

Trystula

et al . Novel PARADIGM in carotid revascularisation: Prospective evaluation of All-comer peRcutaneous cArotiD revascularisation in symptomatic and Increased-risk asymptomatic carotid artery stenosis using CGuard™ MicroNet-covered embolic prevention stent system. EuroIntervention. 2016;12:e658-670.

60.

Capoccia

Sirignano

Mansour

et al . Peri-procedural brain lesions prevention in CAS (3PCAS): Randomized trial comparing CGuard™ stent vs. Wallstent™. Int J Cardiol. 2019;279:148-153.

61.

Fröbert

Lagerqvist

Olivecrona

et al . Thrombus aspiration during ST-segment elevation myocardial infarction. N Engl J Med. 2013;369:1587-1597.

62.

Musialek

TASTE-less endpoint of 30-day mortality (and some other issues with TASTE) in evaluating the effectiveness of thrombus aspiration in STEMI: Not the “evidence” to change the current practice of routine consideration of manual thrombus extraction. Polish Heart J. 2014;72:479-487.

63.

O’Neill

Deptuck

Quong

et al . Who says “no” to participating in stroke clinical trials and why: an observational study from the Vancouver Stroke Program. Trials. 2019;20:313.

64.

Eckstein

Reiff

Ringleb

et al ; SPACE 2 Investigators. SPACE-2: A missed opportunity to compare carotid endarterectomy, carotid stenting, and best medical treatment in patients with asymptomatic carotid stenoses. Eur J Vasc Endovasc Surg. 2016;51(6):761–765.

65.

Aboyans

Ricco

Bartelink

MEL

et al . 2017 ESC guidelines on the diagnosis and treatment of peripheral arterial diseases, in collaboration with the European Society for Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg. 2018;55:305–368.

66.

DeMartino

Brooke

Neal

et al . Development of a validated model to predict 30-day stroke and 1-year survival after carotid endarterectomy for asymptomatic stenosis using the Vascular Quality Initiative. J Vasc Surg. 2017;66:433-444.

67.

Musialek

Pieniazek

Tracz

et al . Safety of embolic protection device-assisted and unprotected intravascular ultrasound in evaluating carotid artery atherosclerotic lesions. Med Sci Monit. 2012;18:MT7-18.

68.

Solomon

Glick

Russo

et al . Patient preferences for stroke outcomes. Stroke. 1994;25:1721-1725.

69.

Cleveland

Gaines

Venables

GS.

Carotid artery stenosis: Patients should have access to all treatments. BMJ. 2010;340:c1467.

70.

Malas

Dakour-Aridi

Kashyap

et al . Outcomes of transcarotid revascularization with dynamic flow reversal versus carotid endarterectomy in the Transcarotid Revascularization Surveillance Project (Abstract). J Vasc Surg. 2019;69:e95-e96.