Evaluation of Plaque Protrusion Following Carotid Artery Stenting Using 3D-rotational Angiography

Abstract

Objective: Plaque protrusion is one of the current problems with carotid artery stenting (CAS) for carotid artery stenosis, and it may induce delayed postprocedural cerebral infarction. In this study, we evaluate the possibility of using threedimensional rotational angiography (3DRA) to examine the stent lumen during CAS.Methods: First, as a basic experiment, we determined the optimal contrast medium concentration for 3DRA. We then studied the presence or absence of plaque protrusion in 43 patients who underwent CAS at our hospital using 3DRA, intravascular ultrasound (IVUS), or DSA.Results: Optimal contrast medium concentration was determined to be 50% by the basic experiment. In clinical evaluation, plaque protrusion was detected in 12 patients (27.9%) by 3DRA, compared to 7 (16.2%) by IVUS and in 3 (6.9%) by DSA. In patients where plague protrusion was undetected by 3DRA, it was also undetected by IVUS and DSA after CAS. Conclusion:Three dimensional rotational angiography appears to be useful for in-stent plaque protrusion detection.

A Patient with Carotid Mobile Plaques Treated by Carotid Artery Stenting Using a Double-layer Micromesh Stent

“…As CAS using the CASPER stent may be useful to treat mobile plaques due to the possibility of reducing PP compared with conventional stents, a comparative study of treatments using novel devices, such as the CASPER stent, is expected. In addition, although it was not used in the present study, detection of PP using 3D rotational angiography has been reported 28) and its use may be considered.…”