Initial experience with the antithrombogenic-coated CARESTO stent for acute symptomatic cervical internal carotid artery dissections: multicenter study.

Abstract

To evaluate the technical feasibility, safety, and short-term to mid-term efficacy of the antithrombogenic-coated CARESTO stent in the endovascular treatment of acute symptomatic cervical internal carotid artery dissections (CICAD) with hemodynamically relevant stenosis and disabling neurological deficits. This retrospective multicenter study evaluated patients with acute symptomatic CICAD who underwent endovascular treatment with the CARESTO stent. Clinical endpoints included changes in the National Institutes of Health Stroke Scale (NIHSS) and the modified Rankin Scale (mRS) scores. Imaging endpoints assessed vessel patency, arterial diameter improvement, and revascularization success, defined as a modified Thrombolysis in Cerebral Infarction (mTICI) score ≥2b. Safety was evaluated by documenting periprocedural complications. Between January 2023 and May 2025, 31 patients were treated across six participating neurovascular centers. The mean age was 52.3±10.2 years; 54.8% were female. Stent deployment was successful in all cases. In those with intracranial vessel occlusion (n=22), recanalization was achieved in all patients (mTICI 3: 61.3%; mTICI 2c: 22.6%; mTICI 2b: 16.1%). ICA diameter improved from 1.0±0.5 mm to 4.6±0.6 mm. Median NIHSS score decreased from 11 (IQR 8-14.5) to 1 (IQR 1-3) at 3 months; mRS≤2 was achieved in 83.9%. All stents remained patent, with no major complications or deaths. This initial multicenter experience suggests that the CARESTO stent is technically feasible and may offer a safe and effective treatment option for acute CICAD. These findings support further prospective evaluation in larger cohorts.