Endovascular treatment of extracranial carotid artery stenosis using a dual-layer micromesh stents: a systematic review.

We aimed to review the safety and effectiveness of dual-layer micromesh stents for the endovascular treatment of carotid artery stenosis. Electronic bibliographic databases were searched using the words 'micromesh carotid stent'. The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement standards. The search of the Literature retrieved 84 results. After assessment of full texts, 13 papers were included in the study. The analyzed studies included 797 patients, 32.1% of them were symptomatic. The reported technical success rate was 100% in all cases. During early follow-up, complications occurred overall in 16/797 patients (2%: 12 strokes, 3 deaths, and one transient ischemic attack). The study with the longest follow-up reported a survival rate of 82% at 4 years and a stroke-free survival rate of 84% at 4 years. With the limit of low data quality, the use of dual-layer stents was reported to be as safe and effective at 30 days for the endovascular treatment of extracranial carotid artery stenosis. The reported technical success was 100% in all cases. Further data coming from randomized controlled trials and larger cohort studies with longer follow-up are nevertheless needed for a better evaluation.