Angioscopy and Intravascular Ultrasound Assessment of CASPER Rx: A Pilot Feasibility Study.

Tajima, Yosuke; Kubota, Masaaki; Koizumi, Jun; Hayashi, Katsuya; Inaba, Yosuke; Higuchi, Yoshinori · World Neurosurg · 2025

prospective_cohort · Level II

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Abstract

Plaque protrusion (PP) following carotid artery stenting may require postdilation, which carries procedural risks. CASPER Rx dual-layer stent may reduce PP incidence. We evaluated the feasibility of dual imaging-guided selective postdilation strategy. Ten patients underwent carotid artery stenting with CASPER Rx. Poststenting evaluation used both intravascular ultrasound and angioscopy. Postdilation was performed only when PP was detected by either modality. Angioscopy was safely performed in all cases. While intravascular ultrasound detected no PP, angioscopy identified PP in 2 of 10 cases, prompting selective postdilation. No complications or restenosis occurred at 6-month follow-up. This exploratory study suggests that dual imaging-guided selective postdilation is feasible and may reduce risks, warranting further validation.

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