SS05 - Perioperative and 5-Year Outcomes of Carotid Artery Stenting Using a Micro-Mesh Stent with Embolic Protection: A Large Prospective Multicenter Experience.

Thursday, June 11, 2026

8:20 AM - 8:31 AM ET

Location: Hynes CC, Third Level, Ballroom B

Submitting & Presenting Author(s)

gianbattista parlani, MD

Staff Vascular Surgeon
Vascular & Endovascular Surgery, S Maria Misericordia Hospital, Perugia, ITALY
perugia, Umbria, Italy

Co-Author(s)

GI

Giacomo Isernia, MD

Staff Vascular Surgeon
Vascular & Endovascular Surgery, S Maria Misericordia Hospital, Perugia, ITALY
Perugia
cf

ciro ferrer

Staff Vascular Surgeon
Vascular and Endovascular Surgery Unit S. Giovanni-Addolorata Hospital, Rome, Italy
ml

massimo lenti

Staff Vascular Surgeon
Vascular & Endovascular Surgery, S Maria Misericordia Hospital, Perugia, ITALY
Perugia, Umbria
Fd

FrancescoPio del Mastro

Resident Vascular Surgeon
Vascular & Endovascular Surgery, S Maria Misericordia Hospital, Perugia, ITALY
Perugia, Umbria

Senior Author(s)

pC

piergiorgio Cao, MD, FRCS

Vascular Surgeon
University of Perugia
Cotignola

Co-Author(s)

RG

Rocco Giudice

Staff Vascular Surgeon
Vascular and Endovascular Surgery Unit S. Giovanni-Addolorata Hospital, Rome, Italy
CC

Carlo Coscarella

Staff Vascular Surgeon
Vascular and Endovascular Surgery Unit S. Giovanni-Addolorata Hospital, Rome, Italy
LG

Luca Garriboli

Staff Vascular Surgeon
Vascular and Endovascular Surgery Unit IRCCS Ospedale SacroCuore Don Calabria Negrar (Vr) Italy
eF

edoardo Forcella

Staff Vascular Surgeon
Vascular and Endovascular Surgery Unit IRCCS Ospedale SacroCuore Don Calabria Negrar (Vr) Italy
Padova, Veneto
tC

tommaso Castrucci

Staff Vascular Surgeon
Chirurgia Vascolare Ospedale Sant'Eugenio ROMA
sB

stefano Bartoli

Staff Vascular Surgeon
Chirurgia Vascolare Ospedale Sant'Eugenio ROMA
Rome
rC

roberto Chiappa

Staff Vascular Surgeon
Chirurgia Vascolare Ospedale Pertini Roma, Italy
mM

massimiliano Miliarelli

Staff Vascular Surgeon
Chirurgia Vascolare Ospedale Pertini Roma, Italy
GS

Gioele Simonte, MD

Staff Vascular Surgeon
Vascular & Endovascular Surgery, S Maria Misericordia Hospital, Perugia, ITALY
perugia, Umbria

Objectives: The aim of this study was to evaluate the perioperative and mid-term safety and efficacy of the CGuard (InspireMD, Tel Aviv, Israel) micromesh self-expanding stent with embolic protection system (EPS) during carotid artery stenting (CAS).

Methods: A prospective evaluation was conducted on all patients undergoing CAS with the CGuard stent across five vascular surgery departments from January 2015 to October 2025. Primary endpoints included technical success, the combined risk of any stroke or death within 30 days (perioperative), and any ipsilateral stroke during follow-up. Secondary endpoints were stroke, death, transient ischemic attack (TIA), and myocardial infarction (major adverse events, MAE) within 30 days, as well as the rates of ipsilateral stroke, death, and restenosis during follow-up.

Results: A total of 965 consecutive patients underwent 1075 CAS procedures. The cohort was 66% male (n=713) with a mean age of 75.3 +8 years; 113 patients (10.5%) were symptomatic. Mean procedural, fluoroscopy, and contrast media volumes were 37 minutes, 13 minutes, and 49 ml, respectively. Protection devices included proximal protection (n=258), distal filters (n=755), or no protection (n=62). Technical success was 99.5%, with failure occurring in 6 cases due to the inability to cross tight stenoses despite predilation.
At 30 days, TIAs occurred in six patients (0.6%) and minor strokes in four (0.4%). Two patients suffered acute myocardial infarction (AMI), one of whom died on postoperative day 2. Mean post-procedural hospitalization was 1.5 days. The 30-day MAE rate was 1.1%.
During a mean follow-up of 38 months (range 1–120), one patient had an asymptomatic stent occlusion and five experienced restenosis >70%, all successfully treated with secondary stenting. Freedom from restenosis was 99.6% at 30 days, 99.5% at 1 year, 98.5% at 3 years, 97.6% at 5 years and 97.6 at 7 years (figure 1). Freedom from ipsilateral stroke was 99.6% at 30 days, 99.3% at 1 year, 99.3% at 3 years, 98.5% at 5 years and 98.5 at 7 years. Actuarial survival was 99.9% at 30 days, 98.8% at 1 year, 94.1% at 3 years, 86.9% at 5 years and 68,3 at 7 years (figure 2).

Conclusions: Preliminary data suggest that the CGuard stent with EPS is a safe and effective device for the treatment of carotid artery stenosis, demonstrating low perioperative and mid-term neurological event rates and durable patency. Larger multicenter randomized studies are warranted to confirm these findings.