Seven years of CRAFT: Clinical results of a multicenter cohort of carotid artery relining with the CASPER RX stent

IF 2 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases Pub Date : 2025-03-03 DOI:10.1016/j.jstrokecerebrovasdis.2025.108271

Ariel Dahan MD, MSc, FRANZCR , Siddharth M. Kulkarni BA, MD , Calvin Gan MBBS, FRANZCR , Davor Pavlin-Premrl MBBS, BMedSci, FRACP , Kevin Z. Zhou MBBS, BMedSci, FRANZCR , Yifan Ren MD , Viktorija Vainauskaite MB, BCh, BAO , Sara Protto MD , Justin Moore MD, JD (LLB), PhD, MPH, MBA, FRACS , Ronil V. Chandra MBBS, FRANZCR , Winston Chong MBBS, FRANZCR, CCINR , Lee-Anne Slater FRANZCR, CCINR , Mohamed Nasra MD , Ali Khabaza FRANZCR, CCINR, EBIR , Julian Maingard MBBS, FRANZCR , Ashu Jhamb MBBS (Hons), FRANZCR , Hong Kuan Kok MBBS, FRANZCR, FRCR , Mark D. Brooks MBBS, FRANZCR, CCINR , Christen D. Barras MBBS, BMedSci, FRANZCR, MMed, PhD , Hamed Asadi MD, PhD, FRANZCR, CCINR

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引用次数: 0

Abstract

Background and Purpose

Carotid artery stenting (CAS) is an established treatment for carotid stenosis or occlusion. Use of the dual-layer microporous CASPER RX stent has had mixed results in prior reports. The CaRotid Artery Filtering Technique (CRAFT) uses the distal end of the CASPER stent as an embolic protection device during deployment. We present the largest cohort of patients having undergone CAS with the CASPER stent and report our multicentre experience with CRAFT over the last seven years.

Materials and Methods

All patients undergoing CAS at three tertiary neurointerventional centres in Australia from April 2016 to April 2023 were included. Patient demographic, procedural and clinical data were retrospectively collected. All included patients underwent CAS with CASPER stent insertion using CRAFT.

Results

215 patients (74 % male, mean age 70) were included in the study. Most patients (89 %) were treated on an emergent basis with 81 % of these representing tandem lesions in acute ischaemic stroke. Median NIHSS score was 12 on admission and 6 post-procedure. 98 % achieved an mTICI score of 2b or higher. Median mRS score was 1 at the time of earliest outpatient follow-up. 90 % of patients received intraprocedural antiplatelet therapy. 10 % suffered symptomatic intracranial haemorrhage and 7 % had stent occlusion. An 8 % all-cause mortality rate was observed.

Conclusion

Emergent CAS with the CASPER RX stent and CRAFT is both safe and efficacious, with low rates of stent occlusion and restenosis as well as a low risk of major complication. Given the limited sample of elective patients in our cohort, further studies are required to corroborate the safety profile of CRAFT in elective CAS

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来源期刊

Journal of Stroke & Cerebrovascular Diseases Medicine-Surgery

CiteScore

5.00

自引率

4.00%

发文量

583

审稿时长

62 days

期刊介绍： The Journal of Stroke & Cerebrovascular Diseases publishes original papers on basic and clinical science related to the fields of stroke and cerebrovascular diseases. The Journal also features review articles, controversies, methods and technical notes, selected case reports and other original articles of special nature. Its editorial mission is to focus on prevention and repair of cerebrovascular disease. Clinical papers emphasize medical and surgical aspects of stroke, clinical trials and design, epidemiology, stroke care delivery systems and outcomes, imaging sciences and rehabilitation of stroke. The Journal will be of special interest to specialists involved in caring for patients with cerebrovascular disease, including neurologists, neurosurgeons and cardiologists.