Skip to main content
SpringerLink
Log in

The Effect of Stent Cell Geometry on Carotid Stenting Outcomes

  • Clinical Investigation
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to investigate the effect of stent cell geometry on midterm results of carotid artery stenting (CAS).

Materials and Method

One hundred fifty-five patients underwent CAS between February 2010 and December 2012. Ninety-one open- and 84 closed-cell stents were used in this non-randomized, retrospective study. Periprocedural complications were defined as the ones happened during the procedure or within 30 days afterwards. Starting from the 6th month after the procedure, in-stent restenosis was detected with multidetector computed tomography angiography and classified into four groups from focal restenosis to occlusion.

Results

Eleven complications were encountered in the periprocedural period (four on the open- and seven on the closed-cell group). Total complication rate was 6.3 % (11/175). No significant difference was detected in terms of periprocedural complications between two groups (p = 0.643). There was statistically significant difference between stent design groups in regard to radiological findings (p = 0.002). Sixteen of open-cell stents and three of closed-cell stents had focal restenosis. One closed-cell stent had diffuse proliferative restenosis and one open-cell stent had total occlusion.

Conclusion

In-stent restenosis was more common in open-cell stent group, which have larger free cell area than closed-cell stents. Although our radiologic findings promote us to use closed-cell design if ‘possible’, no difference was detected in terms of clinical outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Bosiers M, de Donato G, Deloose K, Verbist J, Peeters P, Castriota F, Cremonesi A, Setacci C. Does free cell area influence the outcome in carotid artery stenting? Eur J Vasc Endovasc Surg. 2007;33:135–41.

    Article  CAS  PubMed  Google Scholar 

  2. Hernández-Fernández F, Parrilla G, García-Villalba B, Espinosa de Rueda M, Zamarro J, Garrote M, Moreno A. Comparison between proximal versus distal protection devices in 287 cases of carotid revascularization using angioplasty and stenting: periprocedure complications, morbidity, and mortality. Cardiovasc Interv Radiol. 2014;37:639–45.

    Article  Google Scholar 

  3. Goode SD, Cleveland TJ, Gaines PA. United Kingdom carotid artery stent registry: short- and long-term outcomes. Cardiovasc Interv Radiol. 2013;36:1221–31.

    Article  CAS  Google Scholar 

  4. Müller-Hülsbeck S, Schäfer PJ, Charalambous N, Schaffner SR, Heller M, Jahnke T. Comparison of carotid stents: an in vitro experiment focusing on stent design. J Endovasc Ther. 2009;16:168–77.

    Article  PubMed  Google Scholar 

  5. Spies C, Doshi R, Spoon J, Snell RJ. Carotid artery stent type influences duplex ultrasonography derived peak systolic velocity: findings of an in-vitromodel. Catheter Cardiovasc Interv. 2007;70:309–15.

    Article  PubMed  Google Scholar 

  6. Hussain HG, Aparajita R, Khan SZ, Rezayat C, McKinsey JF, Dayal R. Closed-cell stents present with higher velocities on duplex ultrasound compared with open-cell stents after carotid intervention: short- and mid-term results. Ann Vasc Surg. 2011;25:55–63.

    Article  PubMed  Google Scholar 

  7. Pierce DS, Rosero EB, Modrall JG, Adams-Huet B, Valentine RJ, Clagett GP, Timaran CH. Open-cell versus closed-cell stent design differences in blood flow velocities after carotid stenting. J Vasc Surg. 2009;49:602–6.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Mehran R, Dangas G, Abizaid AS, Mintz GS, Lansky AJ, Satler LF, Pichard AD, Kent KM, Stone GW, Leon MB. Angiographic patterns of in-stent restenosis: classification and implications for long-term outcome. Circulation. 1999;100:1872–8.

    Article  CAS  PubMed  Google Scholar 

  9. Hart JP, Peeters P, Verbist J, Deloose K, Bosiers M. Do device characteristics impact outcome in carotid artery stenting? J VascSurg. 2006;44:725–30.

    Google Scholar 

  10. Reiff T, Amiri H, Rohde S, Hacke W, Ringleb PA. Statins reduce peri-procedural complications in carotid stenting. Eur J Vasc Endovasc Surg. 2014;48:626–32.

    Article  CAS  PubMed  Google Scholar 

  11. Tadros RO, Vouyouka AG, Chung C, Malik RK, Krishnan P, Ellozy SH, Marin ML, Faries PL. The effect of statin use on embolic potential during carotid angioplasty and stenting. Ann Vasc Surg. 2013;27:96–103.

    Article  PubMed  Google Scholar 

  12. Takayama K, Taki W, Toma N, Nakahara I, Maeda M, Tanemura H, Kuroiwa T, Imai K, Sakamoto M, Nakagawa I, Masuo O, Myouchin K, Wada T, Suzuki H. Effect of pitavastatin on preventing ischemic complications with carotid artery stenting: a multicenter prospective study–EPOCH-CAS study. Cardiovasc Interv Radiol. 2014;37:1436–43.

    Article  Google Scholar 

  13. Pizzolato R, Hirsch JA, Romero JM. Imaging challenges of carotid artery in-stent restenosis. J Neurointerv Surg. 2014;6:32–41.

    Article  PubMed  Google Scholar 

  14. Wasser K, Schnaudigel S, Wohlfahrt J, Psychogios MN, Knauth M, Gröschel K. Inflammation and in-stent restenosis: the role of serum markers and stent characteristics in carotid artery stenting. PLoS One. 2011;6:e22683.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. de Donato G, Setacci C, Deloose K, Peeters P, Cremonesi A, Bosiers M. Long-term results of carotid artery stenting. J Vasc Surg. 2008;48:1431–40.

    Article  PubMed  Google Scholar 

  16. Maleux G, Marrannes J, Heye S, Daenens K, Verhamme P, Thijs V. Outcome of carotid artery stenting at 2 years follow-up: comparison of nitinol open cell versus stainless steel closed cell stent design. J Cardiovasc Surg. 2009;50:669–75.

    CAS  Google Scholar 

  17. Hart JP, Bosiers M, Deloose K, Uflacker R, Schönholz CJ. Impact of stent design on the outcome of intervention for carotid bifurcation stenosis. J Cardiovasc Surg. 2010;51:799–806.

    CAS  Google Scholar 

  18. Nolz R, Wibmer A, Beitzke D, Gentzsch S, Willfort-Ehringer A, Lammer J, Thurnher M, Schoder M. Carotid artery stenting and follow-up: value of 64-MSCT angiography as complementary imaging method to color-coded duplex sonography. Eur J Radiol. 2012;81:89–94.

    Article  PubMed  Google Scholar 

  19. Lettau M, Kotter E, Bendszus M, Hähnel S. Carotid artery stents on CT angiography: in vitro comparison of different stent designs and sizes using 16-, 64- and 320-row CT scanners. J Neuroradiol. 2014;41:259–68.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Radiology Clinic, Yozgat State Hospital, Yozgat, Turkey

    Burcu Alparslan

  2. Department of Radiology, Uludag University Faculty of Medicine, Bursa, Turkey

    Omer Fatih Nas & Bahattin Hakyemez

  3. Radiology Clinic, Special Eregli Anatolia Hospital, Zonguldak, Turkey

    Ulku Turpcu Eritmen

  4. Neurology Clinic, Yerkoy State Hospital, Yozgat, Turkey

    Selcen Duran

  5. Department of Biostatistics, Uludag University Faculty of Medicine, Bursa, Turkey

    Guven Ozkaya

Authors
  1. Burcu Alparslan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Omer Fatih Nas
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ulku Turpcu Eritmen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Selcen Duran
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Guven Ozkaya
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Bahattin Hakyemez
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Omer Fatih Nas.

Ethics declarations

Conflict of interest disclosure

The authors declared no conflicts of interest.

Ethical Approval

For this type of study formal consent is not required.

Informed Consent

Does not apply.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Alparslan, B., Nas, O.F., Eritmen, U.T. et al. The Effect of Stent Cell Geometry on Carotid Stenting Outcomes. Cardiovasc Intervent Radiol 39, 507–513 (2016). https://doi.org/10.1007/s00270-015-1211-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00270-015-1211-3

Keywords

Search

Navigation