Seungnam Son1, Dae Seob Choi2, Min Kyun Oh3, Soo-Kyoung Kim1, Heeyoung Kang4, Ki-Jong Park4, Nack-Cheon Choi5, Oh-Young Kwon4, Byeong Hoon Lim5. 1. Department of Neurology, Gyeongsang National University School of Medicine, Jinju, Korea Gyeongnam Regional Cardiocerebrovascular Disease Center, Jinju, Korea. 2. Gyeongnam Regional Cardiocerebrovascular Disease Center, Jinju, Korea Department of Radiology, Gyeongsang National University School of Medicine, Jinju, Korea Gyeongsang Institute of Health Science, Gyeongsang National University School of Medicine, Jinju, Korea. 3. Gyeongnam Regional Cardiocerebrovascular Disease Center, Jinju, Korea Gyeongsang Institute of Health Science, Gyeongsang National University School of Medicine, Jinju, Korea Rehabilitation Medicine, Gyeongsang National University School of Medicine, Jinju, Korea. 4. Department of Neurology, Gyeongsang National University School of Medicine, Jinju, Korea Gyeongsang Institute of Health Science, Gyeongsang National University School of Medicine, Jinju, Korea. 5. Department of Neurology, Gyeongsang National University School of Medicine, Jinju, Korea Gyeongnam Regional Cardiocerebrovascular Disease Center, Jinju, Korea Gyeongsang Institute of Health Science, Gyeongsang National University School of Medicine, Jinju, Korea.
Abstract
BACKGROUND: The feasibility, safety and effectiveness of emergency carotid artery stenting (eCAS) in patients with acute ischemic stroke (AIS) due to proximal internal carotid artery (ICA) stenosis or occlusion are still controversial. In this study we analyzed our experience with eCAS in patients with AIS. METHODS: Twenty-two eCAS procedures for proximal ICA stenosis or occlusion were performed in 22 patients at our institution between January 2011 and November 2013. The mean time from stroke symptom onset to presentation was 204 min (range 50-630 min) and the mean initial score on the National Institutes of Health Stroke Scale (NIHSS) was 12.55 (range 5-23). Ten patients had total occlusion of the proximal ICA and the remaining 12 patients had near total occlusion or severe stenosis (mean degree 90.7%, range 80-100%). Eleven patients also had tandem occlusion on the more distal intracranial arteries. RESULTS: Successful stent insertion was achieved in all patients and additional thrombectomy using a Solitaire stent or Penumbra aspiration catheter achieved a Thrombolysis In Cerebral Infarction grade of more than 2a in all patients with distal tandem occlusion. Procedure-related complications occurred in one patient (cerebral hyperperfusion syndrome) who recovered successfully. The mean NIHSS score at discharge was 3.55 (range 0-18). The mean modified Rankin Scale score at 3 months was 1 ± 1.67 (range 0-6). CONCLUSIONS: eCAS in patients with AIS due to proximal ICA stenosis or occlusion appears to be a technically feasible and effective method for achieving good clinical outcomes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
BACKGROUND: The feasibility, safety and effectiveness of emergency carotid artery stenting (eCAS) in patients with acute ischemic stroke (AIS) due to proximal internal carotid artery (ICA) stenosis or occlusion are still controversial. In this study we analyzed our experience with eCAS in patients with AIS. METHODS: Twenty-two eCAS procedures for proximal ICA stenosis or occlusion were performed in 22 patients at our institution between January 2011 and November 2013. The mean time from stroke symptom onset to presentation was 204 min (range 50-630 min) and the mean initial score on the National Institutes of Health Stroke Scale (NIHSS) was 12.55 (range 5-23). Ten patients had total occlusion of the proximal ICA and the remaining 12 patients had near total occlusion or severe stenosis (mean degree 90.7%, range 80-100%). Eleven patients also had tandem occlusion on the more distal intracranial arteries. RESULTS: Successful stent insertion was achieved in all patients and additional thrombectomy using a Solitaire stent or Penumbra aspiration catheter achieved a Thrombolysis In Cerebral Infarction grade of more than 2a in all patients with distal tandem occlusion. Procedure-related complications occurred in one patient (cerebral hyperperfusion syndrome) who recovered successfully. The mean NIHSS score at discharge was 3.55 (range 0-18). The mean modified Rankin Scale score at 3 months was 1 ± 1.67 (range 0-6). CONCLUSIONS: eCAS in patients with AIS due to proximal ICA stenosis or occlusion appears to be a technically feasible and effective method for achieving good clinical outcomes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Authors: Sung E Park; Dae S Choi; Hye J Baek; Kyeong H Ryu; Ji Y Ha; Ho C Choi; Sangmin Lee; Jungho Won; Seunguk Jung Journal: Interv Neuroradiol Date: 2020-01-28 Impact factor: 1.610
Authors: Joyce Hellegering; Maarten Uyttenboogaart; Reinoud P H Bokkers; Mostafa El Moumni; Clark J Zeebregts; Maarten J van der Laan Journal: Ann Transl Med Date: 2020-10