Using the Casper Stent in Carotid Angioplasty: A Single Center Experience

Objectives To establish the success rate in endovascular internal carotid artery (ICA) stenosis recanalization using the double-layer stent Casper-RX (Microvention, Inc 35 Enterprise, Aliso Viejo, California, United States of America) and to identify the main comorbidities in individuals with ICA stenosis, morphological characteristics of the stenosis, diagnostic methods, intraoperative complications, as well as morbidity and mortality within 30 days of the surgical procedure. Materials and Methods Retrospective analysis of 116 patients undergoing ICA angioplasty with a degree of stenosis ≥ 70% using Casper-RX stenting who underwent this procedure from April 2015 to December 2019. Results Technical success was achieved in 99.1% of the patients. Three of them had postprocedural complications: one transient ischemic attack (TIA) and two puncture site hematomas. A cerebral protection filter was not used in only two procedures, as these consisted of dissection of the carotid. There was satisfactory recanalization and adequate accommodation of the stents in the previously stenosed arteries, with no restenosis in 99.4% of the cases. Conclusion The endovascular treatment of extracranial carotid stenoses using the Casper-RX stent showed good applicability and efficacy. Although only two cases of thromboembolic complications occurred during the procedure, further investigation and studies on the effectiveness of this new device are needed.

Use of distal protection filter device for rescue mechanical thrombectomy for symptomatic free-floating thrombus of the cervical internal carotid artery

Background Intraluminal free floating thrombus (FFT) of the cervical internal carotid artery (ICA) is a potentially high-risk lesion for recurrent ischemic strokes, with no single optimal treatment established. Objective To describe a novel interventional technique for mechanical thrombectomy of intraluminal free floating thrombus using a distal protection filter device and aspiration. Methods We identified two cases where anticoagulation was contraindicated in patients with intraluminal FFT and minimal underlying stenosis. In both cases, a distal protection device was used to extract the thrombus under proximal flow arrest and aspiration. Results Mechanical thrombectomy was successful in both cases, one with “en bloc” removal of the thrombus and one with piecemeal removal. Neither case showed any residual angiographic stenosis or atherosclerotic disease. Conclusion Mechanical thrombectomy using a distal protection device is a novel and technically feasible approach for select cases of cervical intraluminal thrombus. This may represent a therapeutic option in select cases with high risk of anticoagulation and in the unusual subset of younger patients with minimal atherosclerotidc disease.

Synthesis of hierarchically mesoporous silica with encapsulated avobenzone as a UV protection filter

This study provides a preparing method for mesoporous silica to effectively encapsulate with avobenzone.

Green Roof Design: State of the Art on Technology and Materials

In order to consider green roofs as an environmentally friendly technology, the selection of efficient and sustainable components is extremely important. Previous review papers have mainly focused on the performance and advantages of green roofs. The objective of this paper is to examine the primary layers: The waterproof and anti-root membranes; the protection, filter, and drainage layers; the substrate; and the vegetation. First, the history, modern applications, benefits and classification are analyzed in order to present a well-defined state of the art of this technology. Then, the roles, requirements, characteristics, and materials are assessed for each green roof layers. This technology was compared to a conventional roof technology, Mediterranean climate conditions and their influence on green roof design were assessed, also comparing them with Tropical area and focusing on irrigation systems, examples about the commercial materials and products available in the market were provided and innovative materials coming from recycled sources were analyzed. Future research should evaluate new materials for green roof technologies, in order to enhance their performance and increase their sustainability. The information provided in this review paper will be useful to develop Mediterranean green roof guidelines for selecting suitable components and materials during the design and installation phases.