Endovascular treatment of extracranial carotid artery stenosis using a dual-layer micromesh stents: a systematic review

Mazzaccaro, Daniela; Giannetta, Matteo; Fancoli, Fabiana; Righini, Paolo; Nano, Giovanni

doi:10.1080/17434440.2021.1927707

Cited by 5 publications

(4 citation statements)

References 18 publications

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“…However, available data remain very limited and only small studies have been published, indicating optimistic results [ 55 – 57 ]. Short- and long-term safety and efficacy of a dual-layer micromesh stent (DLMS) has already been shown in a number of studies [ 21 , 58 , 59 ]. A current multi-national, multi-specialty study aims to expand the clinical evidence base and confirm the good performance of the DLMS, now in a large, unselected patient cohort eligible for an elective CAS treatment as per routine care.…”

Section: Discussionmentioning

confidence: 99%

CIRSE Standards of Practice on Carotid Artery Stenting

Spiliopoulos,

Blanc,

Gandini

et al. 2024

Cardiovasc Intervent Radiol

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Background Carotid artery stenting has been used effectively to treat internal carotid artery stenosis since 1989 (Mathias et al. in World J Surg. 25(3):328-34, 2001), with refined and expanded techniques and tools presently delivering outstanding results in percutaneous endoluminal treatment of carotid artery stenosis. Purpose This CIRSE Standards of Practice document is directed at interventional radiologists and details the guidelines for carotid artery stenting, as well as the different implementation techniques. In addition to updating all previously published material on the different clinical indications, it will provide all technical details reflective of European practice for carotid artery stenting. CIRSE Standards of Practice documents do not aim to implement a standard of clinical patient care, but rather to provide a realistic strategy and best practices for the execution of this procedure. Methods The writing group, which was established by the CIRSE Standards of Practice Committee, consisted of five clinicians with internationally recognised expertise in carotid artery stenting procedures. The writing group reviewed existing literature on carotid artery stenting procedures, performing a pragmatic evidence search using PubMed to select relevant publications in the English language from 2006 to 2022. Results Carotid artery stenting has an established role in the management of internal carotid artery stenosis; this Standards of Practice document provides up-to-date recommendations for its safe performance.

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Section: Discussionmentioning

confidence: 99%

CIRSE Standards of Practice on Carotid Artery Stenting

Spiliopoulos,

Blanc,

Gandini

et al. 2024

Cardiovasc Intervent Radiol

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“…For stents, the first few months after implantation appear to be the most critical, as survival rates as low as 87% were reported within the first year [ 340 , 341 , 342 , 343 , 344 , 345 ]. Most of these early failures appear to be caused by misplacement and migration or in-stent restenosis, but mechanical failures (fractures or inadequate expansions) and infections were also frequently reported.…”

Section: Long-term Survival Ratesmentioning

confidence: 99%

“…Low survival rates at about 3 years after implantation were also occasionally reported for stents, and this is again associated with the specific patient cohorts [340][341][342][343][344][345]. Patients requiring a stent often exhibit multiple risk factors that increase the likelihood of implant failure, including conditions such as obesity, diabetes, hypertension, smoking, and a history of cardiovascular diseases [354,355].…”

Section: Surface Modification Of Titaniummentioning

confidence: 99%

Biomedical Applications of Titanium Alloys: A Comprehensive Review

Marin,

Lanzutti

2023

Materials

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Titanium alloys have emerged as the most successful metallic material to ever be applied in the field of biomedical engineering. This comprehensive review covers the history of titanium in medicine, the properties of titanium and its alloys, the production technologies used to produce biomedical implants, and the most common uses for titanium and its alloys, ranging from orthopedic implants to dental prosthetics and cardiovascular devices. At the core of this success lies the combination of machinability, mechanical strength, biocompatibility, and corrosion resistance. This unique combination of useful traits has positioned titanium alloys as an indispensable material for biomedical engineering applications, enabling safer, more durable, and more efficient treatments for patients affected by various kinds of pathologies. This review takes an in-depth journey into the inherent properties that define titanium alloys and which of them are advantageous for biomedical use. It explores their production techniques and the fabrication methodologies that are utilized to machine them into their final shape. The biomedical applications of titanium alloys are then categorized and described in detail, focusing on which specific advantages titanium alloys are present when compared to other materials. This review not only captures the current state of the art, but also explores the future possibilities and limitations of titanium alloys applied in the biomedical field.

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“…The use of DLMS is associated with a low rate of major adverse events, and good mid-to-long-term treatment outcomes [ 5 – 7 ]. Advanced imaging studies confirm good lesion scaffolding properties and plaque prolapse limiting capacity of DLMS [ 8 – 11 ].…”

Section: Introductionmentioning

confidence: 99%

“Real-World Study of a Dual-Layer Micromesh Stent in Elective Treatment of Symptomatic and Asymptomatic Carotid Artery Stenosis (ROADSAVER)”

Kedev

Müller‐Hülsbeck

Langhoff

2022

Cardiovasc Intervent Radiol

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Purpose Endovascular carotid artery stenosis treatment is associated with a higher peri- and early post-procedural stroke risk relative to surgery. Dual-layer micromesh carotid stents were specifically designed for improved plaque coverage to reduce the cerebral embolization risk and related ischemic events. ROADSAVER study aims to further confirm the safety and efficacy of the Roadsaver™ dual-layer micromesh stent for the treatment of elective patients with carotid artery stenosis. Materials and Methods ROADSAVER is a prospective, multi-center, observational study. Between January 2018 and February 2021, a total of 1967 patients featuring asymptomatic or symptomatic, non-occlusive and non-thrombotic carotid stenosis eligible for an elective stenting procedure were enrolled across 13 European countries (52 centers). Follow-up visits are scheduled at 30 days and at 12 months. The primary outcome measure is the major adverse event rate, i.e., cumulative incidence of any death or stroke up to 30 days post-procedure. All deaths, strokes and carotid revascularizations are adjudicated by an independent Clinical Events Committee. Sub-analyses are prespecified and focused on baseline patient characteristics (e.g., age, neurologic status), procedural features (e.g., access route, embolic protection use), advanced imaging, and treatment efficacy up to 12 months. Conclusion The present study evaluates the Roadsaver™ dual-layer micromesh carotid stent in the real-world clinical practice aiming to provide valuable insights into the contemporary European treatment trends and outcomes of elective carotid artery stenting. The large study population and predefined sub-analyses should help identify the best practices and patient subsets to benefit most from the treatment. Trial Registration Clinicaltrial.gov identifier: NCT03504228.

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Endovascular treatment of extracranial carotid artery stenosis using a dual-layer micromesh stents: a systematic review

Cited by 5 publications

References 18 publications

CIRSE Standards of Practice on Carotid Artery Stenting

CIRSE Standards of Practice on Carotid Artery Stenting

Biomedical Applications of Titanium Alloys: A Comprehensive Review

“Real-World Study of a Dual-Layer Micromesh Stent in Elective Treatment of Symptomatic and Asymptomatic Carotid Artery Stenosis (ROADSAVER)”

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