title: Incidence of New Ischaemic Brain Lesions After Carotid Artery Stenting with the Micromesh Roadsaver Carotid Artery Stent: A Prospective Single-Centre Study.
abstract: OBJECTIVE
  Several randomized trials of patients with carotid stenosis show increased adverse neurological events with stenting versus endarterectomy in the 30-day post-procedure. This study examines the incidence of new ischaemic lesions in patients treated in our centre using the new Roadsaver stent.
  
  
  RESULTS
  Between September 2015 and January 2016, 23 consecutive patients (age 74.3 ± 7.3 years, 17.4 % female) underwent carotid artery stenting with the Roadsaver stent, a nitinol double-layer micromesh device. A distal protection device was used in all cases. Diffusion-weighted magnetic resonance imaging was performed 24 h before, and 24 h and 30 days after the procedure. The 24-h post-procedure imaging showed 15 new ipsilateral ischaemic lesions in 7 (30.4 %) patients: median volume 0.076 cm3(interquartile range 0.065-0.146 cm3). All lesions were asymptomatic. The 30-day imaging showed complete resolution of all lesions and no new ischaemic lesions. Follow-up clinical and ultrasound examinations at 30 days and 6 months recorded no adverse cardiac or cerebrovascular events.
  
  
  CONCLUSIONS
  Protected stenting with micromesh Roadsaver stent showed good safety and efficacy in the treatment of carotid stenosis, with a low incidence of delayed embolic events and new ipsilateral ischaemic brain lesions. These preliminary results are encouraging, but need to be confirmed with larger populations.
authors: Vascular Radiology Unit, Department of Diagnostic Imaging and Radiotherapy, Azienda Ospedaliera Universitaria- Città della Salute e della Scienza di Torino, San Giovanni Battista Hospital, Corso Bramante 88, 10126, Turin, Italy. mruffino@cittadellasalute.to.it.
authors: Maria Antonella
authors: http://orcid.org/0000-0002-4357-2821
authors: MA
authors: Ruffino
authors: Radiology Unit, Department of Surgical Sciences, University of Torino, Azienda Ospedaliera Universitaria- Città della Salute e della Scienza di Torino, San Giovanni Battista Hospital, Turin, Italy.
authors: Riccardo
authors: R
authors: Faletti
authors: Department of Surgical Sciences, University of Torino, Azienda Ospedaliera Universitaria- Città della Salute e della Scienza di Torino, San Giovanni Battista Hospital, Turin, Italy.
authors: Laura
authors: L
authors: Bergamasco
authors: Radiology Unit, Department of Surgical Sciences, University of Torino, Azienda Ospedaliera Universitaria- Città della Salute e della Scienza di Torino, San Giovanni Battista Hospital, Turin, Italy.
authors: Paolo
authors: P
authors: Fonio
authors: Vascular Radiology Unit, Department of Diagnostic Imaging and Radiotherapy, Azienda Ospedaliera Universitaria- Città della Salute e della Scienza di Torino, San Giovanni Battista Hospital, Corso Bramante 88, 10126, Turin, Italy.
authors: Dorico
authors: D
authors: Righi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000497:Alloys; D002545:Brain Ischemia / Q000000981:diagnostic imaging / Q000628:therapy*; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000628:therapy*; D038524:Diffusion Magnetic Resonance Imaging; D004867:Equipment Design; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D015607:Stents / Q000009:adverse effects; D020521:Stroke / Q000000981:diagnostic imaging / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D000497:Alloys; C013616:nitinol
keywords: Carotid stenting; Diffusion-weighted magnetic resonance; Embolic protection; Internal carotid artery stenosis; Ischaemic brain lesions; Micromesh stent