ArticleJournal of neuroendovascular therapy2026
Early Clinical Experience with Carotid Artery Stenting for Internal Carotid Artery Stenosis Using the Protcas GW Protection System.
Article in Journal of neuroendovascular therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: Carotid artery stenting (CAS) using a distal balloon protection device (DBPD), which had been widely used in Japan, became difficult to perform after the discontinuation of the PercuSurge GuardWire (Medtronic, Minneapolis, MN, USA) in April 2021. The Protcas GW protection device (SB-KAWASUMI LABORATORIES, Kanagawa, Japan) was subsequently developed as a new DBPD; however, its clinical use has not yet been reported. In this study, we describe our initial clinical experience with the Protcas GW and evaluate its efficacy and safety in real-world practice. Methods: We retrospectively analyzed consecutive patients who underwent CAS using the Protcas GW between April 15, 2025 and August 31, 2025 at a single center in Japan. Patient demographics, characteristics of the stenotic lesions, and procedural details were collected. Clinical outcomes included technical success, device-related adverse events, and the composite of any stroke, myocardial infarction, or death during the periprocedural period. Results: A total of 10 patients were included. The median age was 76 years (interquartile range [IQR], 75-84), and the cohort consisted of 9 men and 1 woman. Eight patients had symptomatic stenosis. The median North American Symptomatic Carotid Endarterectomy Trial (NASCET) stenosis severity was 56.5% (IQR, 52.3-65.3), and unstable plaque was identified in 5 cases. The median plaque length was 18.5 mm (IQR, 15-23.8 mm). CAS using the Protcas GW was successful in all cases. One case required device replacement due to inadequate distal balloon inflation; no other device-related adverse events were observed. No periprocedural events occurred in the composite outcome of any stroke, myocardial infarction, or death. Asymptomatic diffusion-weighted imaging-positive lesions were detected in 3 cases on postoperative MRI, with lesion counts of 1, 1, and 2, respectively. Conclusion: In this initial clinical experience, CAS performed using the Protcas GW device was completed successfully without major device-related adverse events, indicating that the procedure can be performed safely.
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