J Korean Soc Radiol.  2020 May;81(3):665-675. 10.3348/jksr.2020.81.3.665.

Predictors of a Favorable Outcome after Emergent Carotid Artery Stenting in Acute Anterior Circulation Stroke Patients

• Moon GI
• Baek BH
• Kim SK
• Lee YY
• Lee HJ
• Yoon W

• KMID: 2502362
• DOI: http://doi.org/10.3348/jksr.2020.81.3.665

Abstract

Purpose
This study aimed to identify independent predictors of favorable outcomes associated with emergent carotid artery stenting (CAS) in patients with acute anterior circulation stroke.
Materials and Methods
This study included 93 patients with acute stroke who underwent emergent CAS to treat stenoocclusive lesions in the cervical internal carotid artery (ICA) within 6 hours of the onset of the associated symptoms. Data were compared between patients with and without favorable outcomes. The independent predictors of a favorable outcome were determined via logistic regression analysis (modified Rankin Scale 0–2 at 90 days).
Results
Intracranial tandem occlusion was noted in 81.7% of patients (76/93) among which (76/93), 55 of whom underwent intracranial recanalization therapy. Intracranial reperfusion was successful in 74.2% (69/93) and favorable outcomes were noted in 51.6% of patients (48/93). The mortality rate was 6.5% (6/93). In logistic regression analysis, diffusion-weighted imaging-Alberta Stroke Program Early CT Score [odds ratio (OR), 1.487; 95% confidence interval (CI), 1.018–2.173, p = 0.04], successful reperfusion (OR, 5.199; 95% CI, 1.566–17.265, p = 0.007), and parenchymal hemorrhage (OR, 0.042; 95% CI, 0.003–0.522, p = 0.014) were independently associated with a favorable outcome.
Conclusion
Baseline infarct size, reperfusion status, and parenchymal hemorrhage were independent predictors of favorable outcomes after emergent CAS to treat stenoocclusive lesions in the cervical ICA in patients with acute anterior circulation stroke.

Keyword

Carotid Artery Stenting; Acute Stroke; Thrombectomy; Prognosis