title: Three-Dimensional Optical Frequency Domain Imaging Evaluation of Novel Dual-Layered Carotid Stent Implantation for Vulnerable Carotid Plaque.
abstract: Plaque prolapse through the cell stent has been suggested as one of the major causes of postprocedural distal embolization after carotid artery stenting. A CASPER stent (Terumo, Tokyo, Japan) is the latest-generation stent having the dual layers and expected to reduce the risk of embolization. A 76-year-old male asymptomatic patient with high-grade stenosis in the left internal carotid artery received carotid artery stenting. Preoperative magnetic resonance imaging demonstrated very high intensity signals on T1-weighted images. After a predilatation, a CASPER stent, which has a dual-layer design construction with an inner nitinol micromesh woven onto an external closed-cell stent, was deployed followed by postdilatation. Postprocedural optical frequency domain imaging revealed good apposition of the outer stent to the vascular wall and no significant prolapse of plaque materials between the struts of the inner micromesh. No ischemic lesions were identified on MRI and no abnormal neurological findings were noted after stenting.
authors.affiliation: Department of Neurology, Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan; Department of Neurosurgery, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: Seigo
authors.initials: S
authors.lastname: Shindo
authors.affiliation: Cardiovascular Division, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Fujii
authors.affiliation: Department of Neurosurgery, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Shirakawa
authors.affiliation: Department of Neurosurgery, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Uchida
authors.affiliation: Department of Neurosurgery, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: Yuri
authors.initials: Y
authors.lastname: Sugiura
authors.affiliation: Department of Neurosurgery, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: Shin
authors.initials: S
authors.lastname: Saito
authors.affiliation: Department of Neurology, Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan.
authors.forename: Yukio
authors.initials: Y
authors.lastname: Ando
authors.affiliation: Department of Neurosurgery, Hyogo College of Medicine, Nishinomiya, Japan. Electronic address: shinyoshi523@gmail.com.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Yoshimura
mesh_terms: D000800:Angioplasty, Balloon / Q000379:methods*; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000473:pathology; D016893:Carotid Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*
keywords: CASPER stent; Carotid artery stenting; optical frequency domain imaging; plaque prolapse