Clinical Results and Mechanical Properties of the Carotid CGUARD Double-Layered Embolic Prevention Stent

Wissgott, Christian; Schmidt, W. J.; Brandt-Wunderlich, Christoph; Behrens, P.; Andresen, Reimer

doi:10.1177/1526602816671134

Cited by 48 publications

(98 citation statements)

References 22 publications

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“…The article by Wissgott et al 62 on the carotid CGuard double-layered embolic prevention stent in the February 2017 issue of the JEVT represents the journal's most recent contribution to the cutting-edge developments in CAS that has included dual-layer stent technology [63][64][65] and new data on the evolution of intraprocedural cerebral protection. 58,66 Following on their work with the RoadSaver doublelayer stent [Terumo, Tokyo, Japan; branded as Casper for commercialization in neuroradiology by Microvention/ Terumo, Saint-Germain-en-Laye, France), 65 Wissgott and colleagues 62 continue their work by evaluating another major dual-layer stent: the CGuard embolic prevention stent (EPS) system (InspireMD, Boston, MA, USA).…”

Section: Novel Double-layered Carotid Stent Systemsmentioning

confidence: 99%

“…58,66 Following on their work with the RoadSaver doublelayer stent [Terumo, Tokyo, Japan; branded as Casper for commercialization in neuroradiology by Microvention/ Terumo, Saint-Germain-en-Laye, France), 65 Wissgott and colleagues 62 continue their work by evaluating another major dual-layer stent: the CGuard embolic prevention stent (EPS) system (InspireMD, Boston, MA, USA). As in their prior work, they provide a thorough evaluation of the mechanical properties of the new prevention stent.…”

Section: Novel Double-layered Carotid Stent Systemsmentioning

confidence: 99%

“…Finally, the position of the mesh in relation to the nitinol frame varies: outside the frame for the CGuard EPS and Gore stent and inside in the case of the RoadSaver/Casper. 61,62,65,67 The RoadSaver/Casper stent delivery system is low profile and very flexible. Similar to the Wallstent, it is resheathable up to 50% of the released stent length, which may offer a procedural advantage to some operators.…”

Section: Mesh-covered Stent Familymentioning

confidence: 99%

“…This makes the CGuard EPS (with 6-F outer diameter of the packed delivery system) the most "open" and, at the same time, the most "closed"-cell carotid stent among the current designs. 11 Unsurprisingly, the tightly packed ultra-closed-cell mesh CGuard has a relatively high bending stiffness prior to delivery, 62 but after implantation it shows an extremely high flexibility and wall adaptation 62 exceeding that of RoadSaver/Casper. 65 CGuard EPS has a high radial force that is similar to the Precise stent and is higher than that of RoadSaver/Casper.…”

Section: Mesh-covered Stent Familymentioning

confidence: 99%

“…65 CGuard EPS has a high radial force that is similar to the Precise stent and is higher than that of RoadSaver/Casper. 62,65 In bench tests by Wissgott and colleagues, 62 CGuard showed both in a step model and in a curved model adaptation to vascular anatomies that was superior to RoadSaver/Casper.…”

Section: Mesh-covered Stent Familymentioning

confidence: 99%

See 4 more Smart Citations

Commentary: Carotid Artery Revascularization for Stroke Prevention

Musiałek

Hopf-Jensen

2016

J Endovasc Ther

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Section: Novel Double-layered Carotid Stent Systemsmentioning

confidence: 99%

Section: Novel Double-layered Carotid Stent Systemsmentioning

confidence: 99%

Section: Mesh-covered Stent Familymentioning

confidence: 99%

Section: Mesh-covered Stent Familymentioning

confidence: 99%

Section: Mesh-covered Stent Familymentioning

confidence: 99%

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Commentary: Carotid Artery Revascularization for Stroke Prevention

Musiałek

Hopf-Jensen

2016

J Endovasc Ther

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Highly‐calcific carotid lesions endovascular management in symptomatic and increased‐stroke‐risk asymptomatic patients using the CGuard™ dual‐layer carotid stent system: Analysis from the PARADIGM study

Mazurek

Partyka²,

Trystuła

et al. 2019

Cathet Cardio Intervent

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Objectives To assess feasibility, safety, angiographic, and clinical outcome of highly‐calcific carotid stenosis (HCCS) endovascular management using CGuard™ dual‐layer carotid stents. Background HCCS has been a challenge to carotid artery stenting (CAS) using conventional stents. CGuard combines a high‐radial‐force open‐cell frame conformability with MicroNet sealing properties. Methods The PARADIGM study is prospectively assessing routine CGuard use in all‐comer carotid revascularization patients; the focus of the present analysis is HCCS versus non‐HCCS lesions. Angiographic HCCS (core laboratory evaluation) required calcific segment length to lesion length ≥2/3, minimal calcification thickness ≥3 mm, circularity (≥3 quadrants), and calcification severity grade ≥3 (carotid calcification severity scoring system [CCSS]; G0‐G4). Results One hundred and one consecutive patients (51–86 years, 54.4% symptomatic; 106 lesions) received CAS (16 HCCS and 90 non‐HCCS); eight others (two HCCS) were treated surgically. CCSS evaluation was reproducible, with weighted kappa (95% CI) of 0.73 (0.58–0.88) and 0.83 (0.71–0.94) for inter‐ and intra‐observer reproducibility respectively. HCCS postdilatation pressures were higher than those in non‐HCCS; 22 (20–24) versus 20 (18–24) atm, p = .028; median (Q1–Q3). Angiography‐optimized HCCS‐CAS was feasible and free of contrast extravasation or clinical complications. Overall residual diameter stenosis was single‐digit but it was higher in HCCS; 9 (4–17) versus 3 (1–7) %, p = .002. At 30 days and 12 months HCCS in‐stent velocities were normal and there were no adverse clinical events. Conclusion CGuard HCCS endovascular management was feasible and safe. A novel algorithm to grade carotid artery calcification severity was reproducible and applicable in clinical study setting. Larger HCCS series and longer‐term follow‐up are warranted.

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Evaluation of the stress relaxation behavior of poly (L‐lactic acid) self‐expanding braided stents

Cheng,

Zhao,

et al. 2023

Polymers for Advanced Techs

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Stress relaxation of poly (L‐lactic acid) (PLLA) braided stents generated after crimping will significantly influence the radial properties of the stents, due to the viscoelasticity of PLLA. In particular, the environmental temperature and duration in the relaxation process are two vital effects on these radial performances. Thereby, a serious of crimping temperatures and holding durations were adopted in this study to investigate their influence on the radial properties of stents. The radial properties of the stent, including peak compression force, chronic outward force and energy loss, were characterized by radial mechanical tests. Results showed that the stress relaxation rates of PLLA braided stents increased with the increase of the crimp‐holding temperature and time. Specifically, the stress relaxation rates at 25, 37 and 42°C were 22.81%, 28.41% and 36.10% at hold time of 300 s. Moreover, the increase of stress relaxation can reduce chronic outward force of stents, which will furtherly cause complications such as insufficient supporting and the shift of stent and so on. Therefore, decreasing the crimp‐holding temperature and duration of stents is an effective method to reduce the stent stress relaxation. This work provides experimental references for the comprehensive evaluation of mechanical properties of PLLA braided stent in clinical application.

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Clinical Results and Mechanical Properties of the Carotid CGUARD Double-Layered Embolic Prevention Stent

Abstract: Because of its structure, the novel CGUARD EPS stent is characterized by a high flexibility combined with a high radial force and very good plaque coverage. These first clinical results demonstrate a very safe implantation behavior without any stroke up to 6 months after the procedure.

Cited by 48 publications

References 22 publications

Commentary: Carotid Artery Revascularization for Stroke Prevention

Commentary: Carotid Artery Revascularization for Stroke Prevention

Highly‐calcific carotid lesions endovascular management in symptomatic and increased‐stroke‐risk asymptomatic patients using the CGuard™ dual‐layer carotid stent system: Analysis from the PARADIGM study

Evaluation of the stress relaxation behavior of poly (L‐lactic acid) self‐expanding braided stents

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