Bending stiffness and trackability of carotid stent delivery systems: Bench-top insights for neurointerventional practice.

Abstract

BackgroundA stable guiding system is essential for successful carotid artery stenting (CAS), particularly when navigating tortuous aortic or supra-aortic anatomy. However, data on the mechanical behavior of stent delivery systems remain scarce.ObjectiveTo assess and compare the bending stiffness and trackability of five commercially available carotid stent delivery systems using bench-top experiments.MethodsFive stent systems-CASPER RX, PRECISE PRO RX, PROTÉGÉ RX, PROTÉGÉ RX Tapered, and Carotid WALLSTENT-were evaluated. Bending stiffness was measured via a three-point bending test along a 20 cm length from the distal tip. Trackability was assessed by measuring resistance force during simulated advancement through a 6F guiding sheath within a 90° angulated vessel model.ResultsCASPER RX demonstrated the lowest bending stiffness in the stent-mounted segment (85-118 cN), whereas the Carotid WALLSTENT had the lowest stiffness in the delivery-shaft segment (120-180 cN). Systems with higher bending stiffness exhibited increased resistance during trackability testing. A correlation between increased bending stiffness and higher advancement resistance was observed across all platforms.ConclusionsCarotid stent delivery systems exhibit diverse mechanical behaviors that impact navigability through tortuous anatomy. Awareness of these mechanical properties can inform device selection and technique optimization during transradial or anatomically challenging CAS procedures.