title: Incidence of embolism associated with carotid artery stenting: open-cell versus closed-cell stents.
abstract: OBJECTIVE
  Carotid artery stenting (CAS) can be an alternative option for carotid endarterectomy in the prevention of ischemic stroke caused by carotid artery stenosis. The purpose of this study was to evaluate the influence of stent design on the incidence of procedural and postprocedural embolism associated with CAS treatment.
  
  
  METHODS
  Ninety-six symptomatic and asymptomatic patients, consisting of 79 males and 17 females, with moderate to severe carotid artery stenosis and a mean age of 69.0 years were treated with CAS. The stent type (48 closed-cell and 48 open-cell stents) was randomly allocated before the procedure. Imaging, procedural, and clinical outcomes were assessed and compared. The symptomatic subgroup (76 patients) was also analyzed to determine the influence of stent design on outcome.
  
  
  RESULTS
  New lesions on postprocedural diffusion-weighted imaging (DWI) were significantly more frequent in the open-cell than in the closed-cell stent group (24 vs 12, respectively; p = 0.020). The 30-day clinical outcome was not different between the 2 stent groups. In the symptomatic patient group, stent design (p = 0.017, OR 4.173) and recent smoking history (p = 0.036, OR 4.755) were strong risk factors for new lesions on postprocedural DWI.
  
  
  CONCLUSIONS
  Stent design may have an influence on the risk of new embolism, and selecting the appropriate stent may improve outcome.
authors.affiliation: Department of Radiology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Keun Young
authors.initials: KY
authors.lastname: Park
authors.forename: Dong Ik
authors.initials: DI
authors.lastname: Kim
authors.forename: Byung Moon
authors.initials: BM
authors.lastname: Kim
authors.forename: Hyo Suk
authors.initials: HS
authors.lastname: Nam
authors.forename: Young Dae
authors.initials: YD
authors.lastname: Kim
authors.forename: Ji Hoe
authors.initials: JH
authors.lastname: Heo
authors.forename: Dong Joon
authors.initials: DJ
authors.lastname: Kim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016893:Carotid Stenosis / Q000150:complications / Q000453:epidemiology* / Q000601:surgery*; D004617:Embolism / Q000209:etiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects* / Q000592:standards; D011183:Postoperative Complications / Q000209:etiology / Q000473:pathology; D015607:Stents / Q000009:adverse effects* / Q000145:classification / Q000592:standards