Casper Carotid Artery Stent System Studied for Reduction of Cerebral DWI Lesion Burden
July 2, 2018—Online in Journal of NeuroInterventional Surgery, Erasmia Broussalis, MD, et al published findings from a study that sought to evaluate the periprocedural cerebral diffusion-weighted imaging (DWI) lesion burden after carotid artery stenting (CAS) with the Casper stent system (MicroVention, Inc., a subsidiary of Terumo). The Caspar device is not cleared or approved by the US Food and Drug Administration for sale or use in the United States.
As summarized in Journal of NeuroInterventional Surgery, the investigators reviewed patients who underwent CAS using the Casper stent system and they determined degrees of carotid stenosis and plaque configuration. All patients were pretreated with dual antiplatelet agents. The investigators obtained cerebral pre- and postprocedural magnetic resonance imaging. All CAS procedures were performed by a single operator.
The investigators reported that a total of 110 patients with severe carotid artery stenosis (median degree of stenosis, 80%; median length of stenosis, 10 mm) were treated with CAS. Hypoechogenic or heterogeneous, mostly hypoechogenic, plaques were documented in 48.6% (52/107) of patients. Carotid ulceration was present in 15.9% (17/107) of patients.
Postprocedurally, 7.3% (8/110) of patients were found to have ischemic DWI lesions; these were asymptomatic in all patients. Follow-up at 90 days was available in 88.2% (97/110) of patients with excellent functional outcome (modified Rankin Scale score, 0–1) in 95.9% (93/97).
CAS using the Caspar stent in combination with a distal embolic protection device is safe and results in a lower rate of periprocedural DWI lesion burden compared with reported results for historic controls, concluded the investigators in Journal of NeuroInterventional Surgery.