Carotid artery stenting using CASPER has a lower incidence of ischemic complications compared to Carotid WALLSTENT, but there is no significant difference in postoperative restenosis

Background The usefulness of CASPER, a second-generation carotid stent, for carotid artery stenosis is becoming increasingly clear. However, few studies have directly compared treatment outcomes with those of the first-generation Carotid WALLSTENT. This study aimed to compare the outcomes of carotid artery stenting using CASPER and Carotid WALLSTENT for carotid artery stenosis performed at a single institution. Methods This retrospective study included 117 consecutive cases (Carotid WALLSTENT, 58 cases; CASPER, 59 cases) where carotid stent placement was performed for internal carotid artery stenosis between 2020 and 2021. Patient background, the presence or absence of ischemic complications as postoperative treatment outcomes, and the presence or absence of restenosis were extracted from the electronic medical records, and the results were compared between the Carotid WALLSTENT and the CASPER treatment groups. Results When comparing ischemic complications between the two groups, the treatment outcomes in the CASPER group were significantly better (Carotid WALLSTENT vs. CASPER: 6 (10.3%) vs. 2 (3.4%), respectively, p = 0.039). However, no significant difference in postoperative restenosis was observed between the two groups. Multivariate analysis revealed that using CASPER significantly reduced ischemic complications (odds ratio: 0.101, 95% confidence interval: 0.0117−0.878). Conclusions Carotid artery stenting using CASPER for internal carotid artery stenosis was associated with fewer ischemic complications than that with the Carotid WALLSTENT. No differences in treatment outcomes were observed with CASPER and Carotid WALLSTENT in terms of postoperative restenosis.