{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T11:34:28Z","timestamp":1761824068549,"version":"3.44.0"},"reference-count":15,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J NeuroIntervent Surg"],"accepted":{"date-parts":[[2018,11,19]]},"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>A new generation of carotid artery stents that use a dual micromesh layer to reduce embolic events during carotid artery stenting has recently been introduced. We aimed to analyze the effectiveness and safety of the new Casper-RX stent in patients experiencing acute ischemic stroke with large vessel intracranial occlusion associated with a tandem lesion (another carotid occlusion or severe stenosis).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We retrospectively analyzed all consecutive patients treated with carotid Casper-RX stents from our stroke registry. We analyzed clinical, angiographic, and neuroimaging data. Endpoints included acute intra-stent thrombus formation, stent occlusion prior to hospital discharge, 3\u2009month modified Rankin Scale score (mRS), and symptomatic intracranial hemorrhage.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>21 patients were included: 10 patients had tandem carotid occlusions and 11 patients had severe carotid stenosis, 8 of whom had a hemodynamically significant stenosis. We observed acute in-stent thrombus formation in 11 patients. No stent occlusion occurred prior to hospital discharge. We report no stroke recurrence at 3 months but symptomatic intracranial hemorrhage in two patients. mRS score at 3 months was 0\u20132 (favorable) for 15 patients (71%), 3\u20135 for 3 patients, and 6 for 3 patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In the present series, we frequently observed clot formation during the procedure with Casper-RX stents, which required periprocedural intravenous infusion of anticoagulant and antiplatelet treatment. This motivated us, in the absence of a prospective randomized controlled study demonstrating the non-inferiority of micromesh dual layer stents compared with the single layer design, to discontinue using this stent type in acute stroke requiring carotid angioplasty.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/neurintsurg-2018-014425","type":"journal-article","created":{"date-parts":[[2018,12,4]],"date-time":"2018-12-04T17:19:28Z","timestamp":1543943968000},"page":"772-774","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":16,"title":["Evaluating the effectiveness and safety of the carotid Casper-RX stent for tandem lesions in acute ischemic stroke"],"prefix":"10.1136","volume":"11","author":[{"given":"Bruno","family":"Bartolini","sequence":"first","affiliation":[{"name":"Department of Radiology, Interventional Neuroradiology Unit, Lausanne University Hospital, Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Puccinelli","sequence":"additional","affiliation":[{"name":"Department of Radiology, Interventional Neuroradiology Unit, Lausanne University Hospital, Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pascal J","family":"Mosimann","sequence":"additional","affiliation":[{"name":"University Institute of Diagnostic and Interventional Neuroradiology, University of Bern, Bern, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven D","family":"Hajdu","sequence":"additional","affiliation":[{"name":"Department of Radiology, Interventional Neuroradiology Unit, Lausanne University Hospital, Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louis","family":"Veunac","sequence":"additional","affiliation":[{"name":"Department of Radiology and Interventional Neuroradiology, CHU de Bordeaux, Bordeaux, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrik","family":"Michel","sequence":"additional","affiliation":[{"name":"Stroke Center, Lausanne University Hospital, Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guillaume","family":"Saliou","sequence":"additional","affiliation":[{"name":"Department of Radiology, Interventional Neuroradiology Unit, Lausanne University Hospital, Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,12,4]]},"reference":[{"key":"2025092912121950000_11.8.772.1","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2016-012913"},{"key":"2025092912121950000_11.8.772.2","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1016\/j.wneu.2017.05.171","article-title":"Potential of new-generation double-layer micromesh stent for carotid artery stenting in patients with unstable plaque: a preliminary result using OFDI analysis","volume":"105","author":"Yamada","year":"2017","journal-title":"World Neurosurg"},{"key":"2025092912121950000_11.8.772.3","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.116.015965"},{"key":"2025092912121950000_11.8.772.4","doi-asserted-by":"publisher","DOI":"10.1177\/1526602815593490"},{"key":"2025092912121950000_11.8.772.5","doi-asserted-by":"crossref","first-page":"neurintsurg-2017-013583","DOI":"10.1136\/neurintsurg-2017-013583","article-title":"The Casper stent system for carotid artery stenosis","volume":"10","author":"Mutzenbach","year":"2018","journal-title":"J Neurointerv 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ischaemic brain lesions after carotid artery stenting with the micromesh roadsaver carotid artery stent: a prospective single-centre study","volume":"39","author":"Ruffino","year":"2016","journal-title":"Cardiovasc Intervent Radiol"},{"key":"2025092912121950000_11.8.772.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2015.04.016"}],"container-title":["Journal of NeuroInterventional 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