Abdullayev N, Maus V, Mpotsaris A, Henning T D, Goertz L, Borggrefe J, Chang D H, Onur O A, Liebig T, Schlamann M, Kabbasch C
Institute for Diagnostic and Interventional Radiology, University Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany.
Institute of Diagnostic and Interventional Radiology, Neuroradiology and Nuclear Medicine, Knappschaftskrankenhaus Bochum, Ruhr University Bochum, In der Schornau 23-25, 44892 Bochum, Germany.
J Clin Neurosci. 2020 May;75:117-121. doi: 10.1016/j.jocn.2020.03.008. Epub 2020 Mar 12.
Stent protected Angioplasty of extracranial carotid artery stenosis using the dual-layered CGUARD stent is a novel treatment option. In this study we evaluate the feasibility and the safety of the CGUARD in symptomatic and asymptomatic patients in comparison to Casper-RX and Wallstent. This is a multi-center study of consecutive patients treated with the CGUARD, Casper-RX and Wallstent at two German high volume neurovascular centers between April 2017 and May 2018. Patient characteristics, neuroimaging data and angiographic outcome were retrospectively analyzed. The primary end points of the study were acute occlusion of the carotid stent and symptomatic intracerebral hemorrhage (sICH). Carotid artery stenting was performed in 76 patients; of those 26 (34%) were treated with the CGUARD, 25 (33%) with Casper-RX, and 25 (33%) with Wallstent. In 58/76 (76%) cases carotid artery stenosis was symptomatic with a median baseline National Institutes of Health Stroke Scale of 4. Angioplasty and stenting as part of a mechanical thrombectomy for acute ischemic stroke was performed in 25/76 (33%) patients. Baseline patient characteristics were similar between the treatment groups, except for a higher portion of scheduled cases in the Casper-RX group. There were no significant differences in the rate of acute in stent occlusions (CGUARD, 2/26 (8%); Casper-RX, 1/25(4%); Wallstent, 1/25 (4%)) and postinterventional sICH (1/26 (4%), 0/25(0%), 0/25 (0%)). Clinical outcome at discharge did not differ between groups. Treatment of carotid artery stenosis using CGUARD is feasible with a good safety profile comparable to that of Casper-RX and Wallstent.
使用双层CGUARD支架对颅外颈动脉狭窄进行支架保护血管成形术是一种新型治疗选择。在本研究中，我们将CGUARD与Casper - RX和Wallstent进行比较，评估其在有症状和无症状患者中的可行性和安全性。这是一项多中心研究，于2017年4月至2018年5月在德国两个高容量神经血管中心对连续接受CGUARD、Casper - RX和Wallstent治疗的患者进行。对患者特征、神经影像学数据和血管造影结果进行回顾性分析。该研究的主要终点是颈动脉支架急性闭塞和有症状的脑出血（sICH）。76例患者接受了颈动脉支架置入术；其中26例（34%）接受CGUARD治疗，25例（33%）接受Casper - RX治疗，25例（33%）接受Wallstent治疗。在58/76（76%）例中，颈动脉狭窄有症状，美国国立卫生研究院卒中量表基线中位数为4。25/76（33%）例患者作为急性缺血性卒中机械取栓术的一部分进行了血管成形术和支架置入术。除Casper - RX组计划病例比例较高外，各治疗组基线患者特征相似。支架内急性闭塞率（CGUARD组为2/26（8%）；Casper - RX组为1/25（4%）；Wallstent组为1/25（4%））和介入后sICH发生率（1/26（4%），0/25（0%），0/25（0%））无显著差异。出院时临床结局在各组间无差异。使用CGUARD治疗颈动脉狭窄是可行的，其安全性良好，与Casper - RX和Wallstent相当。
