Hopf-Jensen Silke, Marques Leonardo, Preiß Michael, Müller-Hülsbeck Stefan
Department of Diagnostic and Interventional Radiology and Neuroradiology, Diakonissenhospital Flensburg, Germany
Department of Diagnostic and Interventional Radiology and Neuroradiology, Diakonissenhospital Flensburg, Germany.
J Endovasc Ther. 2015 Apr;22(2):220-5. doi: 10.1177/1526602815576337.
To assess the effectiveness, technical aspects, handling, and safety of the micromesh Roadsaver Carotid Artery Stent in the treatment of atherosclerotic carotid artery stenosis and tandem lesions in ischemic stroke patients.
Seven patients (5 men; mean age 75±11.4 years, range 53-86) suffering from symptomatic internal carotid artery (ICA) stenosis (mean 76% diameter reduction) were treated with the dual layer closed-cell stent without embolic protection. Postdilation was performed in 6 of 7 patients. Two patients were treated in the context of ischemic stroke and concurrent middle cerebral artery occlusion. Mean National Institutes of Health Stroke Scale score at admission was 12.8±5.
All devices were deployed satisfactorily. One wall-adherent thromboembolus in a proximal ICA was covered with the Roadsaver stent in a tandem lesion setting. The modified Rankin Scale (mRS) declined from 3.7±0.7 to 2.4±0.8 in hospital, showing an improvement in clinical symptoms. No complications were detected during or after the procedure. The 30-day mRS was 1.7±1.1. At 6 months, ultrasound examination demonstrated patency of stents and the external carotid arteries.
The Roadsaver double layer micromesh stent seems to be safe and effective in the treatment of extracranial ICA stenosis and in the context of tandem lesions in ischemic stroke. Further studies with larger populations are warranted.
评估微网Roadsaver颈动脉支架在治疗缺血性脑卒中患者的动脉粥样硬化性颈动脉狭窄及串联病变中的有效性、技术操作、使用便利性和安全性。
7例有症状的颈内动脉(ICA)狭窄(平均直径减少76%)患者(5例男性;平均年龄75±11.4岁,范围53 - 86岁)接受了无栓子保护的双层闭孔支架治疗。7例患者中有6例进行了后扩张。2例患者在缺血性脑卒中及大脑中动脉闭塞的情况下接受治疗。入院时美国国立卫生研究院卒中量表平均评分为12.8±5。
所有装置均成功植入。在串联病变情况下,一枚近端ICA壁附着血栓被Roadsaver支架覆盖。改良Rankin量表(mRS)评分在住院期间从3.7±0.7降至2.4±0.8,临床症状有所改善。手术期间及术后未检测到并发症。30天mRS评分为1.7±1.1。6个月时,超声检查显示支架及颈外动脉通畅。
Roadsaver双层微网支架在治疗颅外ICA狭窄及缺血性脑卒中串联病变方面似乎安全有效。有必要进行更大规模人群的进一步研究。