Percutaneous ultrasound during carotid artery stenting using double-layer stent

Carotid artery stenting (CAS) is one of the treatments for carotid stenosis; however, it is associated with the risk of postoperative embolism due to in-stent plaque protrusion. CASPER Rx (Terumo, Co.) stent is expected to prevent in-stent plaque protrusion because of the double-layered structure. Double-layer segment of the stent is required to be deployed over the carotid plaque during stent placement; however, real-time understanding of the stenting position over the plaque is difficult. Percutaneous ultrasound examination was used during CASPER Rx stent placement for 16 carotid lesions in 12 patients. Ultrasound examination during CAS is useful for detecting position of the plaque and the stent, which can be repositioned, and controlling stent cell density.