A systematic review of carotid stent design and selection: Strategies to optimize procedural outcomes

Carotid artery stenting is an alternative to carotid endarterectomy in select patients. The stroke and death rate following carotid artery stenting must be reduced to allow more general use of this technology. Online databases were utilized to review the impact of stent design. Results specifically for symptomatic patients were reported by four investigators and these data were pooled. A total of 4352 symptomatic patients were pooled (1892 closed cell and 2460 open cell). The odds ratio when comparing open-cell stents with closed-cell stents was 1.35 (95% CI: 0.99-1.83; p = 0.057) for the end point of a 30-day transient ischemic attack, stroke or death. Symptomatic patients with favorable anatomy may have a reduced 30-day risk of transient ischemic attack, stroke or death when closed-cell stents are utilized.