%0 Journal Article
%T A multi-center study of the MicroNET-covered stent in consecutive patients with acute carotid-related stroke: SAFEGUARD-STROKE.
%A Tekieli L
%A Afanasjev A
%A Mazgaj M
%A Borodetsky V
%A Sievert K
%A Ruzsa Z
%A Knapik M
%A Širvinskas A
%A Mazurek A
%A Dzierwa K
%A Sanczuk T
%A Mosenko V
%A Urbanczyk-Zawadzka M
%A Trystula M
%A Paluszek P
%A Wiewiorka L
%A Stefaniak J
%A Pieniazek P
%A Slautaitė I
%A Kwiatkowski T
%A Mackevičius A
%A Teitcher M
%A Sievert H
%A Grunwald IQ
%A Musialek P
%J Postepy Kardiol Interwencyjnej
%V 20
%N 2
%D 2024 Jun
%M 39022700
%F 1.065
%R 10.5114/aic.2024.140963
%X <B>UNASSIGNED: </B>Acute carotid-related stroke (CRS), with its large thrombo-embolic load and large volume of affected brain tissue, poses significant management challenges. First generation (single-layer) carotid stents fail to insulate the athero-thrombotic material; thus they are often non-optimized (increasing thrombosis risk), yet their use is associated with a significant (20-30%) risk of new cerebral embolism.<BR><B>UNASSIGNED: </B>To evaluate, in a multi-center multi-specialty investigator-initiated study, outcomes of the MicroNET-covered (cell area ≈ 0.02-0.03 mm2) carotid stent (CGuard, InspireMD) in consecutive CRS patients eligible for emergency recanalization. Treatment, other than study device use, was according to center/operator routine.<BR><B>UNASSIGNED: </B>Seventy-five patients (age 40-89 years, 26.7% women) were enrolled in 7 interventional stroke centers.<BR><B>UNASSIGNED: </B>The median Alberta Stroke Program Early CT Score (ASPECTS) was 9 (6-10). Study stent use was 100% (no other stent types implanted); retrograde strategy predominated (69.2%) in tandem lesions. Technical success was 100%. Post-dilatation balloon diameter was 4.0 to 8.0 mm. 89% of patients achieved final modified Thrombolysis in Cerebral Infarction (mTICI) 2b-c/3. Glycoprotein IIb/IIIa inhibitor use as intraarterial (IA) bolus + intravenous (IV) infusion was an independent predictor of symptomatic intracranial hemorrhage (OR = 13.9, 95% CI: 5.1-84.5, p < 0.001). The mortality rate was 9.4% in-hospital and 12.2% at 90 days. Ninety-day mRS0-2 was 74.3%, mRS3-5 13.5%; stent patency was 93.2%. Heparin-limited-to-flush predicted patency loss on univariate (OR = 14.3, 95% CI: 1.5-53.1, p < 0.007) but not on multivariate analysis. Small-diameter balloon/absent post-dilatation was an independent predictor of stent patency loss (OR = 15.2, 95% CI: 5.7-73.2, p < 0.001).<BR><B>UNASSIGNED: </B>This largest to-date study of the MicroNET-covered stent in consecutive CRS patients demonstrated a high acute angiographic success rate, high 90-day patency and favorable clinical outcomes despite variability in procedural strategies and pharmacotherapy (SAFEGUARD-STROKE NCT05195658).