Introduction Dual-layer stents have fallen into disrepute after several studies reported high rates of in-stent occlusion in acute stroke. The CGuard stent is a new-generation hybrid dual-layer stent with less thrombogenic material and a special design to prevent postinterventional emboli.

Aim of Study To evaluate the patency and safety of CGuard-stents in an emergent setting, particularly in tandem occlusions.

Methods Consecutive patients from four German stroke centers who underwent emergent carotid artery stenting with CGuard with or without tandem occlusion of the anterior circulation. Clinical, interventional, and imaging data were evaluated. Stent patency at 72 hours, intracranial hemorrhage, and modified Rankin score (mRS) at discharge were the main end points.

Results Overall, Ninety-four patients; age 70.2 ± 11.7; 64 males (68.1%); admission NIHSS 11 (7–17); IV lysis: n=42 (44.7%) were included. Stent placement was successful in all patients, and all stents were patent at the end of the procedure. 67 (71.3%) patients had tandem occlusions. In-stent occlusion occurred in 5 patients (5.3%). Only 3 patients developed in-stent stenosis (3.2%). mRS at discharge was 2 (1–4).

Conclusion In this multicenter study, the use of CGuard for emergent carotid artery stenting, particularly in tandem occlusions, was safe and resulted in lower rates of in-stent occlusions.

Disclosure of Interest The authors stated explicitly that there are no conflicts of interest in connection with this abstract.