Background and Purpose Plaque protrusion (PP) during carotid artery stenting (CAS) using conventional stent was consider to be strongly associated with ischemic complication. Delayed PP also may be associated with stent-thrombosis. Micromesh stent (Casper stent) is double layer stent whose cell size has smaller than conventional stent. Therefore, micromesh stent has been expected to reduce ischemic complication and PP during and after CAS. We investigated incidence of PP during and after CAS using Casper stent.

Material and Methods We prospectively analyzed 74 patients with 81 carotid artery stenoses (58 men; age 54-94 years [mean 76.7 years]; symptomatic stenosis, 36 lesions; mean stenosis rate, 82%) who underwent CAS using Casper stent from October 2020 to March 2023. Technical success rate, incidence of PP during CAS and delayed PP (within 1week after CAS), incidence of ischemic lesions within 48 h after CAS and major adverse event (MAE) (stroke, MI, death) within 30 days were assessed using diffusion weighted images. All CAS was performed by a standard procedure using embolic protection devices.

Result Technical success rate was 100%. PP occurred in one patient (1.2%) during CAS. Delayed PP occurred in three patients (3.7%). Two patients of them were performed with additional stent placement. No stroke was found in these patients. New ischemic lesions were found in twenty patients (26.0%). MAE was observed in one patient without PP (1.2%).

Conclusion Micromesh stent seemed to reduce ischemic complication by preventing PP during CAS. In addition, delayed PP also should be carefully followed-up.

Disclosures K. Takayama: None. K. Myouchin: None. T. Wada: None.