High-Resolution CT and Angiographic Evaluation of NexStent Wall Adaptation

Abstract

Carotid stenting is a minimally invasive treatment for extracranial carotid artery stenosis. Stent design may affect technical success and complications in a certain subgroup of patients. We examined the wall adaptability of a new closed-cell carotid stent (NexStent), which has a unique rolled sheet design. Forty-one patients had 42 carotid arteries treated with angioplasty and stenting for internal carotid artery stenosis. The mean patient age was 65 +/- 10 years. All patients underwent high-resolution computed tomographic angiography after the stent implantation. Data analysis included pre- and postprocedural stenosis, procedure complications, plaque calcification, and stent apposition. We reviewed the angiographic and computed tomographic images for plaque coverage and stent expansion. All procedures were technically successful. Mean stenosis was reduced from 84 +/- 8% before the procedure to 15.7 +/- 7% after stenting. Two patients experienced transient ischemic attack; one patient had bradycardia and hypotension. Stent induced kinking was observed in one case. Good plaque coverage and proper overlapping of the rolled sheet was achieved in all cases. There was weak correlation between the residual stenosis and the amount of calcification. The stent provides adequate expansion and adaptation to the tapering anatomy of the bifurcation.

Parent Vessel Size and Curvature Strongly Influence Risk of Incomplete Stent Apposition in Enterprise Intracranial Aneurysm Stent Coiling

“…By confirming our findings by using FPCT imaging, which has been shown to be effective in the visualization of in vivo stents, 13,14 we demonstrated the same blood flow phenomenon between the stent struts and the vessel wall by using the presence of the CS on 3T-MRA imaging. Univariate and multivariate results from this study demonstrate that following deployment of closed-cell design ENs in the intracranial ICA, ISA is more likely to be found in vessels with more tortuous anatomy.…”

“…Patient subsets with and without CS were statistically indistinguishable with respect to age (60.5 Ϯ 8.0 years and 54.9 Ϯ 10.6 years, respectively, P ϭ .076) and sex (4 men/15 women; and 3 men/17 women, respectively, P ϭ .622). Lengths of ENs (14,22,28, and 37 mm) used in the CSϩ population (n ϭ 0, 17, 1, and 1) were not statistically different (P ϭ .122) than those in the CSϪ population (n ϭ 1, 14, 5, and 0). Similarly, a jailing technique was used in 17 of 19 in patients with CS compared with 16 of 20 in those with CSϪ (P ϭ .408).…”