Stent-assisted endovascular recanalization of extracranial internal carotid artery occlusion in acute ischemic stroke.

Published

Journal Article

Carotid artery occlusions traditionally have extremely poor outcomes with intravenous tissue plasminogen activator treatment or emergent thromboendarterectomy. We retrospectively reviewed our institutional experience with acute carotid occlusions using internal carotid artery endovascular thrombolysis and stent placement.We studied the radiographic and clinical characteristics of 17 patients with an acute cervical internal carotid artery occlusion treated with stent-assisted endovascular thrombolysis. Clinical outcomes were assessed by using National Institute of Health Stroke Scale (NIHSS) scores, which were obtained on admission and discharge. Inclusion criteria were an NIHSS score of at least 6 and the presence of significant penumbra on computed tomographic perfusion. Morbidity and mortality data were collected and analyzed.Seventeen candidates met our inclusion criteria, 16 (94%) of whom had successful immediate recanalization of the internal carotid artery. On admission, the mean NIHSS score was 16.5 and the mean modified Rankin Scale score was 4.8. The mean NIHSS score improved to 6.9 on discharge, with a mean modified Rankin Scale score of 2.88. Eight (47%) patients recovered ambulatory function on discharge. The overall mortality rate of our series was 17%.In the setting of acute ischemic stroke, emergent carotid artery thrombolysis and stenting is a promising treatment for acute carotid occlusions with excellent recanalization rates and favorable clinical outcomes.

Full Text

Duke Authors

Cited Authors

  • Dalyai, RT; Chalouhi, N; Singhal, S; Jabbour, P; Gonzalez, LF; Dumont, AS; Rosenwasser, R; Ghobrial, G; Tjoumakaris, SI

Published Date

  • January 2013

Published In

Volume / Issue

  • 79 / 1

Start / End Page

  • 143 - 148

PubMed ID

  • 23022651

Pubmed Central ID

  • 23022651

Electronic International Standard Serial Number (EISSN)

  • 1878-8769

International Standard Serial Number (ISSN)

  • 1878-8750

Digital Object Identifier (DOI)

  • 10.1016/j.wneu.2012.08.017

Language

  • eng