Diagnostic and Interventional Radiology Department, ASST Santi Paolo e Carlo, San Paolo Hospital, University of Milan, Via A di Rudinì 8, 20142, Milan, Italy.
Vascular Surgery Unit, Surgical Sciences Department, ASST Santi Paolo e Carlo, San Paolo Hospital, University of Milan, Milan, Italy.
Radiol Med. 2019 Jul;124(7):704-709. doi: 10.1007/s11547-019-01019-7. Epub 2019 Mar 2.
To evaluate the incidence of in-stent restenosis (ISR) at 12-month follow-up, in patients treated with new dual-layer Roadsaver (Terumo Corp, Tokyo, Japan) carotid artery stent (CAS).
Thirteen patients underwent CAS and received a Roadsaver. Neurological examination was performed in all patients. Carotid stenosis was revealed by Doppler ultrasound (DUS) and multidetector CT (MDCT) scan. Four patients presented a peak systolic velocity (PSV) between 130 and 150 cm/s, six a PSV between 150 and 180 cm/s, and three a PSV > 180 cm/s. MDCT gave further anatomic information. Direct stenting was performed in 11 (84.6%) cases, whereas in 2 (15.4%) cases predilatation was required. In all cases postdilatation was performed. Technical and clinical success and safety were evaluated. Stent patency was evaluated during the 12-month follow-up.
Technical success was achieved in all cases. In three patients a nonsignificant residual stenosis < 30% has been reported. No major complications during or after the procedure occurred. One patient (7.7%) showed a transitory bradycardia during angioplasty. One (7.7%) local bleeding at the puncture site treated conservatively occurred. All the neurological examinations performed 24 h and 30 days after the procedure were negative. No significant ISR was registered. In 2 patients, < 30% ISR was revealed at DUS performed after 6 months and confirmed at 12 months. In both patients CEUS and MDCT denied the presence of significant stenosis.
Roadsaver stent seems to be durable. Further studies with longer-term outcome are necessary to confirm our results.
评估新型双层 Roadsaver(日本东京 Terumo 公司)颈动脉支架(CAS)治疗患者 12 个月随访时的支架内再狭窄(ISR)发生率。
13 例患者接受了 CAS 并植入了 Roadsaver。所有患者均进行了神经检查。通过多普勒超声(DUS)和多排 CT(MDCT)扫描发现颈动脉狭窄。4 例患者收缩期峰值流速(PSV)在 130-150cm/s 之间,6 例患者 PSV 在 150-180cm/s 之间,3 例患者 PSV>180cm/s。MDCT 提供了进一步的解剖信息。11 例(84.6%)患者直接支架置入,2 例(15.4%)患者需要预扩张。所有病例均行后扩张。评估技术和临床成功率及安全性。在 12 个月的随访期间评估支架通畅性。
所有病例均达到技术成功。3 例患者报告存在无显著意义的残余狭窄<30%。术中或术后无重大并发症发生。1 例(7.7%)患者在血管成形术中出现短暂性心动过缓。1 例(7.7%)患者穿刺部位出现局部出血,予保守治疗。所有患者在术后 24 小时和 30 天进行的神经检查均为阴性。未发现显著的 ISR。2 例患者在 6 个月和 12 个月的 DUS 检查中发现<30%的 ISR。在这 2 例患者中,CEUS 和 MDCT 均否认存在显著狭窄。
Roadsaver 支架似乎是持久的。需要进一步的长期研究来证实我们的结果。