Letter by Musialek et al Regarding Article, “Acute Occlusions of Dual-Layer Carotid Stents After Endovascular Emergency Treatment of Tandem Lesions”
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To the Editor:
Yilmaz et al1 concluded that the recently introduced dual-layered stents have a higher risk of acute occlusion compared with single-layered stents in the treatment of acute stroke. This conclusion is not justified by their study.1
Yilmaz et al1 presented retrospective data for one specific dual-layered carotid stent type. However, dual-layered carotid stent designs exhibit fundamental differences (cf. the review by Musialek et al2 and references therein including the 2016 Journal of Endovascular Therapy commentary by Musialek and Hopf-Jensen, and articles on dual-layered carotid stents characteristics). Although they serve a common goal (minimizing intraprocedural and preventing postprocedural cerebral embolization),2–4 with the stent frame laser cut or braided,2 they differ significantly in mesh design including material and fabrication (poly-ethylene terephthalate or poly-tetra-fluoro-ethylene versus braided nitinol),2 filament size,2 and mesh position relative to frame (outside versus inside).2 Those …