E-219 Dual-layered micromesh stent reduces periprocedural thromboembolism during carotid artery stenting based on near infrared spectroscopy-oriented carotid plaque imaging. (23rd July 2022)

• Record Type: Journal Article
• Authors: Nakagawa, I; Kotsugi, M; Yokoyama, S; Park, H; Maeoka, R; Yamada, S; Nakase, H
• Is Part Of: Journal of neurointerventional surgery. Volume 14(2022)Supplement 1
• Page Start: A199
• Page End: A200
• Publication Date: 2022-07-23
• Subjects: Nervous system -- Surgery -- Periodicals; Cerebrovascular disease -- Surgery -- Periodicals; 617.48
• DOI: 10.1136/neurintsurg-2022-SNIS.330
• Languages: English
• ISSNs: 1759-8478

Abstract

Abstract : Purpose: Near-infrared spectroscopy-intravascular ultrasonography (NIRS-IVUS) is an imaging device that enables real-time identification of lipid components in plaques. Dual-layered micromesh (DLM) stent is available for carotid artery stenosis, however, whether DLM stent reduce periprocedural thromboembolism during carotid artery stenting (CAS) has not been fully elucidated. In this study, we assessed that DLM stent can reduce thromboembolism in patients with lipid core plaque based on NIRS imaging. Methods: From 2017, 161 patients underwent CAS with NIRS-IVUS assessment were included. NIRS assessments are performed before and after CAS, measure lipid core burden index (LCBI), maximum LCBI (maxLCBI), etc. from NIRS-IVUS, and measure plaque signal ratio (T1W-SIR) from preoperative MRI. The effect of DLM stent on embolism compared with standard closed stent was investigated. Results: Although there was no difference in preoperative LCBI values between the two groups, postoperative DWI positive rate was significantly lower in the DLM stent group (n = 28) than in the closed stent group (n = 133) ( p = 0.001), especially in the lipid core plaque (maxLCBI>504; p < 0.001). In addition, Logistic regression analysis indicates high lipid core plaque and non-DLM stent use are related to DWI positive embolism ( p < 0.001, =0.003, respectively). Conclusion: NIRS-IVUS was able to diagnose CAS high-risk lipid core plaques as well as the findings in coronary artery lesions. DLM stents could be a therapeutic option for high-risk lipid core plaques. Disclosures: I. Nakagawa: None. M. Kotsugi: None. S. Yokoyama: None. H. Park: None. R. Maeoka: None. S. Yamada: None. H. Nakase: None.