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Casper vs. Closed-Cell Stent

Carotid Artery Stenting Randomized Trial

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Abstract

Objective

The aim of this trial was to compare the efficacy of closed-cell stents with Casper stents during carotid angioplasty stenting (CAS).

Methods

This was a randomized superiority trial in which 88 patients were enrolled. The primary end points were the incidence, number, and size of new ischemic brain lesions after CAS under distal embolic protection devices (EPD). The secondary end points included stroke, transient ischemic attack (TIA) and myocardial infarction (MI). Ischemic brain lesions were assessed by a diffusion-weighted magnetic resonance image (DW-MRI). Neurological outcomes were evaluated by means of the National Institutes of Health scale score (NIHSS) and the modified Rankin scale (mRS).

Results

Compared with closed-cell stents (n = 47), Casper stents (n = 41), resulted in no significant reduction in the incidence (44.7% versus 39%, P = 0.592), number (1.3 ± 1.8 versus 0.9 ± 1.5, p = 0.444), and size (3.9 ± 5.8 mm versus 2.8 ± 4.1 mm, p = 0.353) of new ischemic brain lesions. The global rate of stroke/TIA/MI was (2/88, 2.3%). Two TIA occurred during the hospitalization period, one in each group (1/41, 2.4% vs 1/47, 2.1%). One patient of the Casper group had an asymptomatic in-stent thrombosis. One patient of the control group had a MI (1/47, 2.1%) after discharge.

Conclusion

The Casper stents did not show superiority in the rate of incidence, number and size of new silent ischemic brain lesions detect by DW-MRI when compared to close cell stents during CAS under distal EPD.

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Authors and Affiliations

  1. Division of Interventional Neuroradiology, Medical School of Passo Fundo, Federal University of South Frontier, Rua Teixeira Soares, 640, Centro, 99080-020, Passo Fundo, RS, Brazil

    José Ricardo Vanzin & Luciano Bambini Manzato

  2. Division of Hematology, Medical School of Passo Fundo, Federal University of South Frontier, Passo Fundo, RS, Brazil

    Moema Nene Santos

  3. Division of Interventional Neuroradiology, Felício Rocho Hospital, Belo Horizonte, Brazil

    Felipe Padovani Trivelato & Marco Túlio Salles Rezende

  4. Division of Interventional Neuroradiology, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil

    José Ricardo Vanzin, Luís Henrique de Castro-Afonso, Guilherme Seizem Nakiri, Lucas Moretti Monsignore, Felipe Padovani Trivelato, Marco Túlio Salles Rezende, Octavio Marques Pontes-Neto & Daniel Giansante Abud

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  1. José Ricardo Vanzin
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  2. Luís Henrique de Castro-Afonso
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Correspondence to José Ricardo Vanzin.

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Conflict of interest

J.R. Vanzin, L.H. de Castro-Afonso, M.N. Santos, L.B. Manzato, G.S. Nakiri, L.M. Monsignore, F.P. Trivelato, M.T.S. Rezende, O.M. Pontes-Neto and D.G. Abud declare that they have no competing interests.

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Vanzin, J.R., de Castro-Afonso, L.H., Santos, M.N. et al. Casper vs. Closed-Cell Stent. Clin Neuroradiol 31, 843–852 (2021). https://doi.org/10.1007/s00062-020-00937-8

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  • DOI: https://doi.org/10.1007/s00062-020-00937-8

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