Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
EuroIntervention. 2017 Dec 20;13(11):1347-1354. doi: 10.4244/EIJ-D-16-00866.
The aim of this study was to identify the findings (by optical coherence tomography [OCT]) after carotid artery stenting (CAS) with two different types of new-generation mesh-covered stent.
Sixteen consecutive patients undergoing CAS with mesh-covered stents and highdefinition OCT image acquisition were enrolled in the study. Cross-sectional OCT images for the presence of strut malapposition (SM) and plaque prolapse (PP) were evaluated using a proximal or distal embolic protection device (EPD). CGuard stents were used in 11 patients (68.8%) and RoadSaver stents in five (31.2%). With OCT analysis, the incidence of SM was 20.5% for CGuard vs. 26.8% for RoadSaver, p=0.26, and the incidence of PP was 10.8% for CGuard vs. 20.7% for RoadSaver, p=0.05. No neurological complications (stroke/TIA) occurred during the procedural and post-procedural periods.
The OCT findings of two different types of mesh-covered stent after CAS were obtained safely. Our work indicates that current mesh-covered carotid stents may show differences in SM and PP. The effect of stent design and implantation technique on OCT findings post CAS, and their relation to longterm clinical outcomes, require further evaluation.
本研究旨在通过光学相干断层扫描(OCT)来识别两种新型编织物覆盖支架行颈动脉支架置入术(CAS)后的影像学表现。
本研究纳入了 16 例行 CAS 并使用编织物覆盖支架和高清 OCT 图像采集的连续患者。使用近端或远端栓塞保护装置(EPD)评估支架贴壁不良(SM)和斑块脱垂(PP)的横断面 OCT 图像。11 例患者(68.8%)使用 CGuard 支架,5 例患者(31.2%)使用 RoadSaver 支架。OCT 分析显示,CGuard 支架的 SM 发生率为 20.5%,RoadSaver 支架的 SM 发生率为 26.8%,p=0.26;CGuard 支架的 PP 发生率为 10.8%,RoadSaver 支架的 PP 发生率为 20.7%,p=0.05。在手术和围手术期期间未发生任何神经并发症(卒中和 TIA)。
本研究安全地获得了两种不同类型编织物覆盖支架行 CAS 后的 OCT 结果。我们的研究表明,当前的编织物覆盖颈动脉支架在 SM 和 PP 方面可能存在差异。支架设计和植入技术对 CAS 后 OCT 结果的影响及其与长期临床结局的关系需要进一步评估。