This registry of daily clinical practice suggests that this specifically designed double-mesh carotid stent is safe and associated with a minimal and acceptable occurrence of neurological events up to 12 months of follow-up.
This double-mesh stent has already been tested, and its short- and long-term efficacy has been proven. However, more recent data have challenged the long-term results, as the device might cause much greater restenosis at 1 year.
Driven by these concerns, a large group of specialist colleagues initiated a multicenter, prospective registry of consecutive patients who had undergone carotid artery stenting with the CGuard device in 20 centers.
The primary endpoint was mortality and stroke at 1 year, and the secondary endpoints included transient ischemic attack, acute myocardial infarction, internal or external carotid intervention, and stent thrombosis.
After one year of follow-up, data were obtained for 726 patients, accounting for 99.04% of the population!
Beyond 30 days, there were 1 minor transient ischemic attack (0.13%), 4 textbook transient ischemic attacks (0.55%), 2 fatal myocardial infarctions (0.27%), and 6 deaths due to a non-cardiac cause (1.10%).
Doppler ultrasound showed internal carotid restenosis in six patients (0.82%); two of them had total occlusion.
Read also: Thrombotic and Bleeding Risk after TAVR: Quick Tips to Stay Up to Date.
No predictors of restenosis, re-occlusion, or events were found. Antiplatelet therapy was sustained for 3 to 6 months.
Conclusion
This real-world registry puts carotid artery stenting to a test once more, this time leveraging the alleged benefits of double-meshed devices, assessing clinical aspects at one year.
Original Title: 1-Year Results From a Prospective Experience on CAS Using the CGuard Stent System-
Reference: Pasqualino Sirignano et al. JACC Cardiovasc Interv. 2021 Sep 13;14(17):1917-1923. doi: 10.1016/j.jcin.2021.05.045.
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