A New Concept for Carotid Artery Stenting: Coating the Atherosclerotic Plaque by Covered Stent before Bare Stent Implantation

Figure 1

Digital subtraction angiogram shows eccentric, short segment plaque in the internal carotid artery next to the carotid bulb (a). After placing a protection filter (Emboshield NAV6), a covered stent (Direct Stent) was deployed to cover the plaque fully (b). In (c), angiogram shows no residual stenosis following both the insertion of a tapered, closed-cell stent (X-act) covering the covered stent and extending from the common to the internal carotid artery and the dilation of a 5 mm balloon. The stents are clearly visible in (d). Follow-up angiogram performed at the 6th (e) month shows no restenosis but minimal intimal hyperplasia inside the stents. The hyperplasia inside the stents is seen unchanged in the 12th-month angiogram (f).

(a)

(b)

(c)

(d)

(e)

(f)