Okumura Eitaro, Onodera Sho, Jimbo Hiroyuki
Department of Neurosurgery, Tokyo Medical University Hachioji Medical Center, Hachioji, Tokyo, Japan.
J Neuroendovasc Ther. 2023;17(8):173-179. doi: 10.5797/jnet.cr.2023-0009. Epub 2023 Jul 7.
CASPER Rx stent (Terumo, Tokyo, Japan) is one of the dual-layer micromesh stents for carotid artery stenosis. Although it is expected to be safe and efficacious even for vulnerable plaque, we report a case of in-stent occlusion 2 weeks after stenting with CASPER Rx stent.
The patient was a 78-year-old man with a symptomatic, severely stenosed lesion of the cervical internal carotid artery (ICA). He had an unstable plaque and underwent carotid artery stenting with the CASPER Rx stent. There were no problems with the procedure or the patient's subsequent course, and he was discharged home 1 week after the procedure. However, on postoperative day 14, the patient had a transit ischemic attack and imaging showed acute occlusion due to thrombus in the stent and in the distal part of the ICA. Mechanical thrombectomy was performed and good recanalization was achieved, but postoperative cerebral infarction was observed and the patient was transferred to other hospital with modified Rankin Scale 2.
We experienced a case of in-stent occlusion 2 weeks after stenting with the CASPER Rx stent.
CASPER Rx支架（日本东京泰尔茂公司）是用于颈动脉狭窄的双层微网孔支架之一。尽管即使对于易损斑块，它也有望安全有效，但我们报告了1例使用CASPER Rx支架置入术后2周出现支架内闭塞的病例。
患者为一名78岁男性，有症状性颈内动脉（ICA）严重狭窄病变。他有不稳定斑块，并接受了CASPER Rx支架颈动脉支架置入术。手术过程及患者随后的病程均无问题，术后1周他出院回家。然而，术后第14天，患者发生短暂性缺血性发作，影像学检查显示由于支架内及ICA远端血栓形成导致急性闭塞。进行了机械取栓术并实现了良好的再通，但观察到术后脑梗死，患者以改良Rankin量表评分为2分被转至其他医院。
我们遇到1例使用CASPER Rx支架置入术后2周出现支架内闭塞的病例。
