Brain with network of arteries and stent.

Stroke Alert: Are New Carotid Stents Safe or Risky?

Soraya Malik in Health & Wellness November 2025 • 4 min read.

"A closer look at the Casper-RX stent and its potential complications in acute ischemic stroke treatment."

When it comes to stroke treatment, every second counts. Doctors are constantly looking for better ways to clear blocked arteries and restore blood flow to the brain as quickly as possible. One approach involves using stents—tiny mesh tubes—to open up narrowed carotid arteries in the neck, especially when there's a blockage in both the neck and brain.

Recently, a new type of carotid stent, the Casper-RX, hit the market. It features a double layer of micromesh designed to trap debris and prevent it from traveling to the brain, potentially reducing the risk of new strokes during the procedure. But real-world results have been mixed, and some doctors are starting to question whether the benefits outweigh the risks.

This article dives into a study that investigated the use of the Casper-RX stent in patients experiencing acute ischemic stroke with tandem lesions—blockages in both the carotid artery and a major vessel in the brain. The study aimed to evaluate how well the stent worked and whether it led to any unexpected complications, shedding light on an ongoing debate in the world of stroke intervention.

Casper-RX Stent: Promising Tech or Risky Procedure?

Brain with network of arteries and stent.

The study, conducted by researchers in Switzerland and France, retrospectively analyzed data from 21 patients who underwent treatment with the Casper-RX stent for acute ischemic stroke between November 2014 and August 2017. All patients had a large vessel occlusion in the brain combined with either a severe narrowing or complete blockage of the carotid artery.

The researchers closely examined clinical, angiographic, and neuroimaging data to assess several key outcomes:

Acute thrombus formation within the stent itself.
Stent occlusion (blockage) before the patient was discharged from the hospital.
Modified Rankin Scale (mRS) score at 3 months—a measure of overall disability.
Symptomatic intracranial hemorrhage (bleeding in the brain).

The results revealed some cause for concern. While no stents completely blocked before discharge, a significant number of patients (11 out of 21) developed acute thrombus formation within the stent during the procedure. This clot formation required additional interventions, such as repeated balloon angioplasty and, in some cases, the administration of intravenous heparin.

The Verdict: Proceed with Caution

While the Casper-RX stent aims to reduce the risk of stroke during carotid angioplasty, this study suggests that it may come with its own set of challenges. The high incidence of thrombus formation within the stent raises concerns about the stent's safety profile in acute stroke settings. The researchers themselves have stopped using this type of stent for acute stroke interventions, pending further research. If you or a loved one are facing a stroke, it's crucial to discuss all available treatment options with your medical team, weighing the potential benefits and risks of each approach.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1136/neurintsurg-2018-014425, Alternate LINK

Title: Evaluating The Effectiveness And Safety Of The Carotid Casper-Rx Stent For Tandem Lesions In Acute Ischemic Stroke

Subject: Neurology (clinical)

Journal: Journal of NeuroInterventional Surgery

Publisher: BMJ

Authors: Bruno Bartolini, Francesco Puccinelli, Pascal J Mosimann, Steven D Hajdu, Louis Veunac, Patrik Michel, Guillaume Saliou

Published: 2018-12-04

Everything You Need To Know

What is the Casper-RX stent, and how is it used in stroke treatment?

The Casper-RX stent is a type of carotid stent featuring a double layer of micromesh designed to trap debris during angioplasty. It's intended to prevent the debris from traveling to the brain, reducing the risk of new strokes during the procedure to open narrowed carotid arteries, especially in patients with blockages in both the neck and brain, a condition known as tandem lesions during acute ischemic stroke.

What were the key findings of the study regarding the use of the Casper-RX stent in patients with acute ischemic stroke?

The study revealed a significant incidence of acute thrombus formation within the Casper-RX stent during the procedure, affecting 11 out of 21 patients. While no stents completely blocked before discharge, this thrombus formation required additional interventions such as repeated balloon angioplasty and the administration of intravenous heparin. Researchers also assessed the Modified Rankin Scale(mRS) to assess disability, and monitored symptomatic intracranial hemorrhage. The study raises concerns about the safety profile of the Casper-RX stent in acute stroke settings.

What are tandem lesions in the context of acute ischemic stroke, and why are they significant?

Tandem lesions refer to blockages in both the carotid artery (in the neck) and a major vessel in the brain during an acute ischemic stroke. They are significant because they complicate treatment strategies and can worsen patient outcomes. The Casper-RX stent was studied specifically in this context to determine its effectiveness in addressing blockages in both locations simultaneously.

What is the Modified Rankin Scale (mRS), and how was it used in the study evaluating the Casper-RX stent?

The Modified Rankin Scale (mRS) is a commonly used scale to measure the degree of disability or dependence in daily activities in people who have suffered a stroke or other neurological disability. In the study, the mRS score at 3 months was assessed to determine the overall disability level of patients who underwent treatment with the Casper-RX stent. This helps to understand the long-term outcomes and the impact of the stent on patient's functional abilities. A lower mRS score indicates less disability.

Given the study's findings, what are the implications for the use of the Casper-RX stent in acute stroke treatment?

The study's findings suggest caution when considering the use of the Casper-RX stent for acute stroke interventions, particularly in cases with tandem lesions. The high incidence of thrombus formation within the stent raises concerns about its safety profile. As a result, the researchers involved in the study have stopped using this type of stent for acute stroke interventions, pending further research. If stroke treatment is needed it's crucial to discuss all available treatment options with a medical team, carefully weighing the potential benefits and risks of each approach, including alternative stent designs or other methods of restoring blood flow. Further research should explore if there are specific patient populations in which Casper-RX stent is more safe.