Impact on outcome of different types of carotid stent: results from the European Registry of Carotid Artery Stenting.
OBJECTIVE
Conflicting data exist on the impact on outcome of the use of different stent types during carotid artery stenting (CAS). The aim of this study was to evaluate clinical outcomes according to different carotid stent design among the population of the European Registry of Carotid Artery Stenting (ERCAS).


RESULTS
The present study was conducted in 1,604 patients who underwent neuroprotected CAS in ERCAS. All types of commercially available carotid stent were used. Open-cell design stents were classified according to free cell area into <7.5 mm2 or >7.5 mm2. A total of 713 closed-cell, 456 hybrid-cell, 238 <7.5 mm2 open-cell, and 197 >7.5 mm2 open-cell stents were implanted. Overall, the 30-day stroke and death rate was 1.37%. At 30 days, 19 strokes occurred (1.18%): eight in the group of patients treated with a closed-cell (1.12%), two in those with a hybrid-cell (0.44%), three in those with a <7.5 mm2 open-cell (1.26%), and six in those treated with a >7.5 mm2 open-cell stent (3.05%) (p=0.045).


CONCLUSIONS
Data of the present study suggest that, in the setting of neuroprotected CAS performed in high-volume centres by properly trained operators, the use of an open-cell design stent with a free cell area >7.5 mm2 may be associated with an increased 30-day stroke risk.
Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.
Eugenio
E
Stabile
Giuseppe
G
Giugliano
Alberto
A
Cremonesi
Marc
M
Bosiers
Bernhard
B
Reimers
Carlo
C
Setacci
Piergiorgio
P
Cao
Andrej
A
Schmidt
Horst
H
Sievert
Patrick
P
Peeters
Dimitrios
D
Nikas
Anna
A
Sannino
Gianmarco
G
de Donato
Giambattista
G
Parlani
Fausto
F
Castriota
Marius
M
Hornung
Paolo
P
Rubino
Giovanni
G
Esposito
Tullio
T
Tesorio
D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty / Q000295:instrumentation / Q000379:methods; D002340:Carotid Artery Diseases / Q000628:therapy*; D016893:Carotid Stenosis / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D015607:Stents / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome