Therapeutic Results after the Introduction of Tailored CAS

Objective: We examined whether the introduction of tailored carotid artery stenting (CAS) was effective for the prevention of periprocedural ischemic complications. Methods: In patients who underwent CAS, we compared the incidence of new ischemic lesions on postprocedural diffusion weighted image (DWI) and periprocedural ischemic stroke between three periods: the early period when primarily distal balloon protection was used, the intermediate period when primarily distal filter protection was used, and the late period after the introduction of tailored CAS. Results: CAS was performed in 16 lesions in the early period, 30 lesions in the intermediate period, and 69 lesions in the late period. New ischemic lesions on postprocedural DWI were detected in 1 (6.3%), 6 (20.0%), and 12 (17.4%), respectively. Periprocedural ischemic stroke occurred in three lesions (10%) during the intermediate period, but did not occurred during the early and late periods. Conclusion: The incidence of new ischemic lesion on DWI did not change even after the introduction of tailored CAS, but no periprocedural ischemic stroke occurred, suggesting that tailored CAS is effective for its prevention.