Introduction and Purpose Internal carotid artery (ICA) angioplasty and stenting is a possible treatment modality for patients with acute stroke that is associated with carotid artery occlusion. Here we investigate the use of this combined technique and evaluate the results and outcomes of carotid artery recanalisation in patients presenting with acute ischaemic stroke.
Methods Over a period of six months, five patients with acute ischaemic stroke associated with cervical ICA occlusion underwent combined ICA angioplasty and stenting. A retrospective review was completed and clinical variables were measured and evaluated. Thrombolysis in cerebral ischaemia (TICI) score was used to define the degree of recanalisation, and a favourable outcome was defined as a Modified Rankin Scale (mRS) score of 0–3 at 90 days.
Results The mean patient age was 60.2 (range49–77) and the mean presenting National Institute of Health Stroke Scale was 17.8 (range16–19). Out of all patients, four had complete occlusion of the left ICA and one had complete occlusion of the right ICA. In four patients there was concomitant intracranial occlusion. The time from symptom onset to endovascular intervention was ≤ 3 hours in three patients, 10 hours in one patient and unknown in the other patient. Internal carotid angioplasty with stenting was completed in all patients. A TICI score greater than IIb was achieved in 100% of patients and grade III was achieved in 60% of patients. The 90 day mRS was 0–2 in 40% of patients and 0–3 in 80% of patients.
Conclusion Clinical outcomes suggest that carotid artery angioplasty when combined with stenting is a useful and reasonable technique for carotid artery recanalisation in patients undergoing an ischaemic stroke. Further studies need to be completed to assess the overall safety and efficacy of this combined technique for use of treatment in acute ischaemic stroke.
Disclosures P. Morone: None. J. Mocco: None.
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