Introduction Double-layer design carotid stents have been cast in a negative light since several investigations reported high rates of in-stent occlusions, at least in the acute setting of tandem occlusion. CGuard is a new generation hybrid double-layered stent and was designed to prevent periinterventional embolic events. Results with the CGuard in elective carotid artery stenting (CAS) are promising. .

Aim of Study: The aim of this study was to analyze the safety of the CGuard for the treatment of tandem occlusions in comparison with the single-layer Carotid Wall stent (CWS) system.

Methods All patients who underwent CAS with CGuard or CWS after mechanical thrombectomy (MTe) were identified from our neuroendovascular registry. Clinical, interventional and neuroimaging data were analyzed. Patency of the stent after 72 hours, intracranial hemorrhage and modified Rankin score (mRS) at discharge were the main endpoints.

Results In total, 86 stent procedures in 86 patients were included (CWS: 44, CGuard: 42). CGuard had a lower, but not statistically significant rate of in-stent occlusions (n=2, 4.8%) when compared to the CWS group (n=4, 9.1%). Significant restenosis was found in one case in each group, respectively. Differences in mRS at discharge were not significant.

Conclusion In our series, the rate of in-stent occlusions after emergent CAS was in tendency lower with the dual-layer CGuard when compared to the monolayer Wall stent. Further data is needed to evaluate the potential benefit of the design in more detail.

Disclosure of Interest FD serves as a proctor/consultant for Cerenovus, Microvention, Balt, Cerus Endovascular, received scientific grant from Cerenovus and speakers honoraria from Acandis, Asahi, Stryker.