Emergent Recanalization with Stenting for Acute Stroke due to Athero-Thrombotic Occlusion of the Cervical Internal Carotid Artery : A Single Center Experience
Journal of Korean Neurosurgical Society 2014³â 55±Ç 6È£ p.313 ~ p.320
ÃÖÀ翵(Choi Jae-Young) - Pusan National University Hospital Department of Neurosurgery
ÀÌÀçÀÏ(Lee Jae-Il) - Pusan National University Hospital Department of Neurosurgery
ÀÌÅÂÈ«(Lee Tae-Hong) - Pusan National University Hospital Department of Diagnostic Radiology
¼º»ó¹Î(Sung Sang-Min) - Pusan National University Hospital Department of Neurology
Á¶ÇÑÁø(Cho Han-Jin) - Pusan National University Hospital Department of Neurology
Abstract
Objective: The purpose of this study is to demonstrate the technical feasibility and clinical efficacy of emergent carotid angioplasty and stenting (CAS) for acute stroke due to athero-thrombotic occlusion of the cervical internal carotid artery (ICA).
Methods: Review of medical records identified 17 patients who underwent emergent CAS for treatment of athero-thrombotic occlusion of the cervical ICA with acute stroke between 2009 and 2013. Eleven patients (64.7%) presented with concomitant intracranial artery occlusion, which was treated primarily by mechanical thrombectomy after CAS.
Results: Successful revascularization of the cervical ICA with emergent CAS was achieved in all patients. After CAS, intracranial recanalization with Thrombolysis in Cerebral Infarction ¡Ã2b flow was achieved in four of the 11 patients (36.4%). The overall recanalization rate (cervical ICA and intracranial artery) was 10 of 17 patients (58.8%). Symptomatic intracranial hemorrhage occurred in two patients (11.8%), resulting in death. Ten patients (58.8%) showed improvement (decrease in NIHSS score of ¡Ã4 points) at seven days after recanalization. Nine patients (52.9%) showed a favorable outcome (mRS ¡Â2) at the last follow-up. A favorable outcome (mRS ¡Â2) was obtained in four of the six patients with isolated cervical ICA occlusion (4/6, 66.7%) and five of 11 patients with intracranial tandem occlusion (5/11, 45.5%).
Conclusion: Emergent CAS for acute stroke due to athero-thrombotic occusion of the cervical ICA showed a good technical feasibility and favorable clinical outcome.
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Carotid stent, Stroke, Carotid occlusion, Thrombolysis
KMID :
1001920140550060313
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