PT  - JOURNAL ARTICLE
AU  - Orlando Diaz
AU  - Gloria Lopez
AU  - John O F Roehm, Jr
AU  - Ginna De la Rosa
AU  - Fernando Orozco
AU  - Rafael Almeida
TI  - The Casper carotid artery stent: a unique all metal micromesh stent designed to prevent embolic release
AID  - 10.1136/neurintsurg-2016-012913
DP  - 2018 Feb 01
TA  - Journal of NeuroInterventional Surgery
PG  - 133--136
VI  - 10
IP  - 2
4099  - http://jnis.bmj.com/content/10/2/133.short
4100  - http://jnis.bmj.com/content/10/2/133.full
SO  - J NeuroIntervent Surg2018 Feb 01; 10
AB  - Background Stroke due to the release of embolic debris during the placement of a stent to correct carotid artery stenosis is a constant procedural and peri-procedural threat. The new all metal Casper stent has been created with two layers of nitinol, the inner layer of which has pores diminutive enough to prevent embolic release.Objective To evaluate the safety, effectiveness, and utility of the double layer nitinol Casper carotid artery stent in the treatment of patients with severe carotid artery stenosis.Methods 19 patients with severe internal carotid artery stenosis, 14 symptomatic and 5 asymptomatic, were treated with the Casper stent. After stent placement, angiographic and cone beam CT images were recorded in all patients.Results The unique low profile delivery system allowed for easy stent placement, re-sheathing, and repositioning of the stent. The large cell external layer produced excellent apposition to the artery wall. The inner layer prevented prolapse of atherosclerotic debris through the device. Plaque coverage was achieved; residual stenosis ranged from 0% to 20%. Long term angiographic follow-up in 5 patients showed wall apposition of the device covering the lesion and no restenosis. There were no procedure related complications. Two patients experienced a delayed ischemic stroke, likely related to inconsistent medical management.Conclusions The Casper has been an excellent stent for the treatment of internal carotid artery stenosis and its internal micromesh layer has been effective in preventing plaque prolapse. It provides the flexibility of large cell stents and the inner layer provides maximum protection against plaque prolapse.