eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
Current issue Archive Manuscripts accepted About the journal Editorial board Abstracting and indexing Subscription Contact Instructions for authors
SCImago Journal & Country Rank
4/2020
vol. 16
 
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abstract:
Original paper

Carotid artery stenting with Roadsaver stent. Early and four-year results from a single-center registry

Roman A. Machnik
1
,
Piotr Pieniążek
1, 2
,
Marcin Misztal
1
,
Krzysztof Plens
3
,
Marek Kazibudzki
1
,
Tomasz Tomaszewski
4
,
Andrzej Brzychczy
1
,
Robert Musiał
5
,
Mariusz Trystuła
1
,
Łukasz M. Tekieli
2

1.
Department of Vascular Surgery and Endovascular Interventions, John Paul II Hospital, Krakow, Poland
2.
Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University, Medical College, John Paul II Hospital, Krakow, Poland
3.
KCRI, Krakow, Poland
4.
Department of Neurology, John Paul II Hospital, Krakow, Poland
5.
Department of Anesthesiology and Intensive Medical Therapy, John Paul II Hospital, Krakow, Poland
Adv Interv Cardiol 2020; 16, 4 (62): 444–451
Online publish date: 2020/12/29
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Aim
To assess immediate and long-term safety and effectiveness of CAS using the Roadsaver double-nitinol-layer-micromesh stent.

Material and methods
Since 2014, 298 CAS procedures in 287 non-consecutive patients (203 men, mean age 70.5 ±8.6 years, 100% symptomatic/high risk lesions) have been performed using the Roadsaver stent and proximal (40%) or distal (60%) neuroprotection system. Clinical and neurological examinations as well as duplex ultrasound were completed before CAS, before discharge, at 1, 6 and 12 months, then annually.

Results
All CAS procedures were successful. Carotid stenosis was reduced from 84.9 ±9.9% to 11.0 ±9.4% (p < 000.1). In hospital, 1 ipsilateral periprocedural major (0.3%) and 3 minor (1.34%) ischemic strokes occurred, 2 (0.7%) patients died due to a cerebral hemorrhage on day 9 and 21. Three (1.0%) additional ipsilateral minor strokes within 30 consecutive days occurred. Thus, 30-day complications were observed in 9 (3.0%) patients. Two minor strokes were associated with in-stent thrombosis (0.7%). The 4-year follow-up showed 82% overall survival (95% CI: 69–91%) with no significant difference between asymptomatic (77%) and symptomatic patients (97%; p = 0.076). The stroke-free survival was 89% (95% CI: 77–95%), 84% asymptomatic vs. 98% symptomatic (p = 0.187). Seven (2.3%) patients developed > 50% in-stent restenosis.

Conclusions
Carotid artery stenting using the Roadsaver stent for symptomatic patients and high risk lesions showed to be safe and effective, with a low complication rate and acceptable in-stent restenosis risk in 4-year follow-up.

keywords:

carotid artery stenting, Roadsaver stent, nitinol double-layer micromesh stent

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