Carotid Artery Stenting Using a Double-layer Micromesh Stent

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  • Yamada Kiyofumi
    Department of Neurosurgery, Kyoto University, Kyoto, Kyoto, Japan Department of Neurosurgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
  • Yoshimura Shinichi
    Department of Neurosurgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
  • Yoshida Kazumichi
    Department of Neurosurgery, Kyoto University, Kyoto, Kyoto, Japan
  • Uchida Kazutaka
    Department of Neurosurgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
  • Shirakawa Manabu
    Department of Neurosurgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
  • Kawasaki Masanori
    Department of Cardiology, Gifu Heart Center, Gifu, Gifu, Japan
  • Miura Masatomo
    Department of Neurology, Kumamoto Red Cross Hospital, Kumamoto, Kumamoto, Japan
  • Ishii Akira
    Department of Neurosurgery, Kyoto University, Kyoto, Kyoto, Japan
  • Kataoka Hiroharu
    Department of Neurosurgery, Kyoto University, Kyoto, Kyoto, Japan
  • Miyamoto Susumu
    Department of Neurosurgery, Kyoto University, Kyoto, Kyoto, Japan

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<p>Carotid artery stenting (CAS) has recently emerged as a potential alternative to carotid endarterectomy (CEA) in Japan. However, one of its disadvantages is the higher incidence of ischemic complications than CEA, such as distal embolism during or after the procedure. Plaque protrusion (PP) through the stent strut after deployment of the stent has been suggested as one of the major causes of distal embolism, especially in patients with unstable plaques. The need for increased plaque coverage to reduce the risk of PP through the stent struts has led to the development of a double-layer micromesh stent (micromesh stent) system. This stent system has already been used clinically in European countries with good short- to medium-term follow-up results. Also clinical trials evaluating micromesh stents have been completed in Japan. Hence, usefulness of the micromesh stent for CAS is expected. According to the results of several clinical studies, CAS with the double-layer micromesh stent has the potential to minimize distal embolism during or after the procedure even in patients with unstable plaques. However, it may not be suitable for emergency CAS at this point. Also, since results of only short- to medium-term follow-up have been reported, longer-term follow-up will be required in the near future.</p>

収録刊行物

  • 脳神経血管内治療

    脳神経血管内治療 14 (10), 407-412, 2020

    特定非営利活動法人 日本脳神経血管内治療学会

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