J Korean Neurol Assoc.  2008 Aug;26(3):177-185.

Emergent Carotid Stenting in Acute Stroke Patients With Steno-Occlusion of Proximal Internal Carotid Artery

• Bae GY
• Hong JH
• Sohn SI
• Sohn CH
• Chang HW

Abstract

BACKGROUND
The aim of this study was to investigate the feasibility and efficacy of emergent carotid artery stenting (CAS) for occlusion or high-grade stenosis of the internal carotid artery (ICA) in patients with acute ischemic stroke.
METHODS
From November 2004 to May 2007, 17 patients admitted to the hospital within 12 hours of symptom onset with occlusion or a high-grade stenosis of the proximal ICA underwent emergent CAS. We analyzed risk factors, imaging findings, functional outcome scales, and peri-procedural complication. The outcome was measured by the modified Rankin scale (mRS) 3 months later and classified into good (mRS score of 0 to 2) or poor (mRS score of 3 to 6).
RESULTS
All patients were recanalized successfully. The median National Institutes of Health Stroke Scale (NIHSS) score was 12.6 (range 4 to 24) just before the emergent CAS, which decreased to 9.4 and 8.2 at 1 day and 7 days after the stenting. Three months later, 12 patients showed good outcome while three had poor outcome and two of them died. Two patients (11.8%) exhibited symptomatic hemorrhagic transformation following the emergent CAS. Smoking status, and initial and immediate post-procedural NIHSS scores were associated with the outcome.
CONCLUSIONS
Emergent CAS is a feasible and effective method in acute treatment of selected stroke patients with steno-occlusion of the proximal ICA.

Keyword

Endovascular therapy; Stent; Internal carotid artery; Acute stroke

MeSH Terms

Carotid Arteries
Carotid Artery, Internal
Constriction, Pathologic
Humans
National Institutes of Health (U.S.)
Risk Factors
Smoke
Smoking
Stents
Stroke
Weights and Measures
Smoke