Wallstent RPを用いた頸動脈ステント : 有用性と問題点について  [in Japanese] Carotid Artery Stenting with the Wallstent RP : Its Advantage and Disadvantage  [in Japanese]

We evaluated the advantages and disadvantages of wire braided stent (Wallstent RP) in 17 patients with carotid stenosis with soft to intermediate plaque. The average age of the patients was 70.6 year-old and 13 of the 17 (76.5%) patients were symptomatic. Carotid arterial stenting was performed using various protection devices, such as PercuSurge, MintCatch or Parodi Anti Emboli System. In 15 of the 17 cases (88.2%) post dilatation was added and was usually performed after nitinol stents were used. Carotid plaques were evaluated by carotid ultrasounds. A diffusion weighted image was performed within 3 days after the procedure. All patients were successfully treated except for 1 who suffered transient ischemic attack after CAS. The morbidity and mortality rates of our series are 0%. The sealing effect of Wallstent RP for carotid plaque was observed with intravascular ultrasound. In 1 patient, carotid artery kinking of the distal side of stent occurred due to the straightening effect of Wallstent RP for the tortuous internal carotid artery. Hyper-intense lesions on DWI were observed only in 33.3% of patients, although 80% of patients had echolucent plaques or ulcerations in carotid ultrasound findings. CAS using Wallstent RP may be effective for carotid artery stenosis with soft plaque.