Benefits and pitfalls of carotid stents with dual-layer design – a systematic review

Czech version

Authors: J. Sýkora ^1,2; K. Zeleňák ¹; M. Vorčák ¹; M. Števík ¹; V. Nosáľ ³; E. Kurča ³; G. Broocks ⁴; L. Meyer ⁴; J. Fiehler ⁴
Authors‘ workplace: Rádiologická klinika JLF UK a UNM, Martin, Slovensko ¹; Rádiologická klinika LF UP a FN Olomouc, ČR ²; Neurologická klinika JLF UK a UNM, Martin, Slovensko ³; Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany ⁴
Published in: Cesk Slov Neurol N 2023; 86(3): 171-176
Category: Review Article
doi: https://doi.org/10.48095/cccsnn2023171

Overview

Aim: Carotid artery stenting is considered an important minimally invasive treatment modality in stenotic carotid artery disease. First-generation carotid stents have been associated with a higher rate of neurologic complications than carotid endarterectomy. To minimize atherosclerotic plaque prolapses and subsequent embolization, a second generation of micromesh-covered stents has been developed. The aim of this systematic review is to describe the main advantages and possible limitations of carotid stents with dual-layer design. Methods: The articles were selected in accordance with the PRISMA guidelines. The databases Scopus, PubMed and Web of Science were searched, 247 publications were selected for analysis, and 128 duplicates were removed. Based on the exclusion criteria, 81 publications were omitted. The reference lists of the 38 remaining articles were reviewed and six additional relevant sources were found. A total of 44 publications were included in the review. Results: Studies show that the use of dual-layer stents reduces the incidence of periprocedural cerebral embolism and the incidence of ipsilateral stroke at 30 days and 12 months both in asymptomatic and symptomatic patients. However, second generation stents show fundamental differences in stent construction and also in their clinical outcomes. Conclusion: The dual-layer stent technology may improve short- and long-term clinical results of carotid artery stenting. Although randomized trials comparing second-generation stents with surgical treatment are lacking, currently published results may significantly influence decision-making in primary and secondary stroke prevention.

Keywords:

dual-layer stent – carotid artery stenting – carotid artery stenosis

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