CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2022; 41(01): e1-e6
DOI: 10.1055/s-0041-1740405
Original Article

Using the Casper Stent in Carotid Angioplasty: A Single Center Experience

O uso do stent casper na angioplastia carotídea: Experiência de único centro
1   Endovascular Neurosurgery Department, Hospital Santa Isabel, Blumenau, SC, Brazil
2   Neurosurgery Department, Universidade Regional de Blumenau, Blumenau, SC, Brazil
,
3   Medicine Department, Universidade Regional de Blumenau, Blumenau, SC, Brazil
,
3   Medicine Department, Universidade Regional de Blumenau, Blumenau, SC, Brazil
,
3   Medicine Department, Universidade Regional de Blumenau, Blumenau, SC, Brazil
,
3   Medicine Department, Universidade Regional de Blumenau, Blumenau, SC, Brazil
,
3   Medicine Department, Universidade Regional de Blumenau, Blumenau, SC, Brazil
,
3   Medicine Department, Universidade Regional de Blumenau, Blumenau, SC, Brazil
,
3   Medicine Department, Universidade Regional de Blumenau, Blumenau, SC, Brazil
,
3   Medicine Department, Universidade Regional de Blumenau, Blumenau, SC, Brazil
,
3   Medicine Department, Universidade Regional de Blumenau, Blumenau, SC, Brazil
,
3   Medicine Department, Universidade Regional de Blumenau, Blumenau, SC, Brazil
,
3   Medicine Department, Universidade Regional de Blumenau, Blumenau, SC, Brazil
,
3   Medicine Department, Universidade Regional de Blumenau, Blumenau, SC, Brazil
› Author Affiliations

Abstract

Objectives To establish the success rate in endovascular internal carotid artery (ICA) stenosis recanalization using the double-layer stent Casper-RX (Microvention, Inc 35 Enterprise, Aliso Viejo, California, United States of America) and to identify the main comorbidities in individuals with ICA stenosis, morphological characteristics of the stenosis, diagnostic methods, intraoperative complications, as well as morbidity and mortality within 30 days of the surgical procedure.

Materials and Methods Retrospective analysis of 116 patients undergoing ICA angioplasty with a degree of stenosis ≥ 70% using Casper-RX stenting who underwent this procedure from April 2015 to December 2019.

Results Technical success was achieved in 99.1% of the patients. Three of them had postprocedural complications: one transient ischemic attack (TIA) and two puncture site hematomas. A cerebral protection filter was not used in only two procedures, as these consisted of dissection of the carotid. There was satisfactory recanalization and adequate accommodation of the stents in the previously stenosed arteries, with no restenosis in 99.4% of the cases.

Conclusion The endovascular treatment of extracranial carotid stenoses using the Casper-RX stent showed good applicability and efficacy. Although only two cases of thromboembolic complications occurred during the procedure, further investigation and studies on the effectiveness of this new device are needed.

Resumo

Objetivos Identificar a taxa de sucesso na recanalização de estenose da artéria carótida interna (ACI) obtida por método endovascular quando utilizado o stent de dupla camada Casper-RX (Microvention, Inc 35 Enterprise, Aliso Viejo, California, United States of America) e identificar as principais comorbidades apresentadas pelos indivíduos com estenose de ACI, características morfológicas das estenoses, métodos utilizados para diagnósticos, ocorrência de complicações transoperatórias e a morbimortalidade nos 30 dias posteriores ao procedimento cirúrgico.

Materiais e métodos Análise retrospectiva de 116 pacientes submetidos a procedimento de angioplastia da ACI com grau de estenose ≥ 70%, com a utilização de stent Casper-RX, durante o período de abril de 2015 a dezembro de 2019.

Resultados O sucesso técnico foi alcançado em 99,1% dos indivíduos. Três pacientes apresentaram complicações pós procedimento, sendo um acidente encefálico transitório (AIT) e dois hematomas de sítio de punção. Em apenas dois procedimentos não se utilizou filtro de proteção cerebral devido tratar-se de dissecção carotídea. Houve satisfatória recanalização e acomodação adequada dos stents nas artérias previamente estenosadas, não havendo reestenose em 99,4% dos casos.

Conclusão O tratamento endovascular das estenoses carotídeas extracranianas com uso do stent Casper-RX demonstrou boa aplicabilidade e eficácia. Apesar de ter apresentado apenas dois casos de complicações tromboembólicas durante o procedimento, são necessárias maiores investigações e estudos sobre a eficácia deste novo dispositivo.

Ethics

The present study was conducted according to the Standard Item Protocol: Recommendations for Interventions (SPIRIT) and was approved by the local ethics committee under CAEE 31685320.0.0000.5370. The Informed Consent Form (ICF) was presented and made available to all individuals in the study.




Publication History

Received: 20 July 2021

Accepted: 06 September 2021

Article published online:
04 January 2022

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