Emergent carotid artery stenting in patients with acute ischemic stroke due to cervical internal carotid artery steno-occlusive lesion: Comparison of tandem intracranial occlusion and isolated cervical internal carotid artery occlusion
Purpose Acute ischemic strokes caused by steno-occlusive lesion of the cervical internal carotid artery are associated with poor clinical outcome. We evaluated the clinical efficacy of emergent carotid artery stenting for the management of these lesions. We compared the clinical outcomes regarding t...
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| Veröffentlicht in: | Interventional neuroradiology 2020-08, Vol.26 (4), p.425-432 |
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| creator | Park, Sung E Choi, Dae S Baek, Hye J Ryu, Kyeong H Ha, Ji Y Choi, Ho C Lee, Sangmin Won, Jungho Jung, Seunguk |
| description | Purpose
Acute ischemic strokes caused by steno-occlusive lesion of the cervical internal carotid artery are associated with poor clinical outcome. We evaluated the clinical efficacy of emergent carotid artery stenting for the management of these lesions. We compared the clinical outcomes regarding the intracranial lesion, namely tandem occlusions versus isolated cervical internal carotid artery occlusion.
Materials and methods
We retrospectively reviewed patients with acute ischemic stroke who underwent carotid artery stenting for cervical internal carotid artery steno-occlusive lesion between 2011 and 2018. After dividing the patients into two groups according to the presence or absence of intracranial lesions (tandem group and isolated cervical group), we analyzed demographic data, angiographic findings, and clinical outcomes. A modified Rankin Scale score ≤2 was defined as a favorable clinical outcome.
Results
Of 75 patients, 46 patients (61.3%) had tandem lesions, and the remaining 29 had only cervical internal carotid artery steno-occlusive lesion. Successful stenting was performed in all patients with favorable clinical outcomes (64.0%). Successful reperfusion score (thrombolysis in cerebral infarction ≥2 b) was 84.0%; tandem group (76.1%) versus isolated cervical group (96.6%) of cases. Mean modified Rankin Scale score at 90-days was 2.09. The rate of favorable clinical outcome showed no statistically significant difference between the two groups (p = 0.454).
Conclusions
Endovascular treatment in patients with acute ischemic stroke due to cervical internal carotid artery steno-occlusive lesion is a technically feasible and clinically effective intervention regardless of intracranial occlusion. Therefore, we recommend endovascular treatment regardless of the presence of concomitant intracranial artery occlusion for patients with acute ischemic stroke caused by cervical internal carotid artery steno-occlusive lesion. |
| doi_str_mv | 10.1177/1591019919899755 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7446583</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_1591019919899755</sage_id><sourcerecordid>2348236470</sourcerecordid><originalsourceid>FETCH-LOGICAL-c434t-2234665b9ecdadc3a7fe6a16eb65b70777ca3aada29efa15bee22af732fb8b763</originalsourceid><addsrcrecordid>eNqFkk1v1DAQhi1ERbctd07IRy4p_kjihAMSWpUPqRKX9mxNnMmuS2IvtrOov5k_gaNdVoBAnGzPvO8z49EQ8oKza86Ves2rljPetrxt2lZV1ROyErKpCsE4f0pWS7pY8ufkIsYHxupKtvwZOZc5JjhTK_L9ZsKwQZeogeCT7SmEhOGRxpSD1m2odXQHyeZXpN9s2lIwc0Jqo9niZE0WBv8FaT8jTZ4aDHtrYMy2jHH58heuL7wx4xztHumI0Xr3hq79tINgo3fUDzSB63FaIAFMAGcz6OjJgpzM9f0ICfv_Vzz5rsjZAGPE58fzkty_v7lbfyxuP3_4tH53W5hSlqkQQpZ1XXUtmh56I0ENWAOvsctBxZRSBiRAD6LFAXjVIQoBg5Ji6JpO1fKSvD1wd3M3YW9w-cWod8FOEB61B6t_zzi71Ru_16os66qRGfDqCAj-64wx6SmPG8cRHPo56txgI2RdKpal7CA1wccYcDiV4UwvO6L_3JFseflreyfDz6XIguIgiLBB_eDnZarx38AfX0HO9w</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2348236470</pqid></control><display><type>article</type><title>Emergent carotid artery stenting in patients with acute ischemic stroke due to cervical internal carotid artery steno-occlusive lesion: Comparison of tandem intracranial occlusion and isolated cervical internal carotid artery occlusion</title><source>Access via SAGE</source><source>MEDLINE</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><creator>Park, Sung E ; Choi, Dae S ; Baek, Hye J ; Ryu, Kyeong H ; Ha, Ji Y ; Choi, Ho C ; Lee, Sangmin ; Won, Jungho ; Jung, Seunguk</creator><creatorcontrib>Park, Sung E ; Choi, Dae S ; Baek, Hye J ; Ryu, Kyeong H ; Ha, Ji Y ; Choi, Ho C ; Lee, Sangmin ; Won, Jungho ; Jung, Seunguk</creatorcontrib><description>Purpose
Acute ischemic strokes caused by steno-occlusive lesion of the cervical internal carotid artery are associated with poor clinical outcome. We evaluated the clinical efficacy of emergent carotid artery stenting for the management of these lesions. We compared the clinical outcomes regarding the intracranial lesion, namely tandem occlusions versus isolated cervical internal carotid artery occlusion.
Materials and methods
We retrospectively reviewed patients with acute ischemic stroke who underwent carotid artery stenting for cervical internal carotid artery steno-occlusive lesion between 2011 and 2018. After dividing the patients into two groups according to the presence or absence of intracranial lesions (tandem group and isolated cervical group), we analyzed demographic data, angiographic findings, and clinical outcomes. A modified Rankin Scale score ≤2 was defined as a favorable clinical outcome.
Results
Of 75 patients, 46 patients (61.3%) had tandem lesions, and the remaining 29 had only cervical internal carotid artery steno-occlusive lesion. Successful stenting was performed in all patients with favorable clinical outcomes (64.0%). Successful reperfusion score (thrombolysis in cerebral infarction ≥2 b) was 84.0%; tandem group (76.1%) versus isolated cervical group (96.6%) of cases. Mean modified Rankin Scale score at 90-days was 2.09. The rate of favorable clinical outcome showed no statistically significant difference between the two groups (p = 0.454).
Conclusions
Endovascular treatment in patients with acute ischemic stroke due to cervical internal carotid artery steno-occlusive lesion is a technically feasible and clinically effective intervention regardless of intracranial occlusion. Therefore, we recommend endovascular treatment regardless of the presence of concomitant intracranial artery occlusion for patients with acute ischemic stroke caused by cervical internal carotid artery steno-occlusive lesion.</description><identifier>ISSN: 1591-0199</identifier><identifier>EISSN: 2385-2011</identifier><identifier>DOI: 10.1177/1591019919899755</identifier><identifier>PMID: 31992107</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Aged ; Aged, 80 and over ; Carotid Artery Stenting ; Carotid Artery, Internal ; Carotid Stenosis - complications ; Carotid Stenosis - diagnostic imaging ; Carotid Stenosis - surgery ; Cerebral Angiography ; Female ; Humans ; Ischemic Stroke - diagnostic imaging ; Ischemic Stroke - etiology ; Ischemic Stroke - surgery ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Retrospective Studies ; Stents ; Thrombectomy ; Thrombolytic Therapy ; Tomography, X-Ray Computed</subject><ispartof>Interventional neuroradiology, 2020-08, Vol.26 (4), p.425-432</ispartof><rights>The Author(s) 2020</rights><rights>The Author(s) 2020 2020 SAGE Publications</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c434t-2234665b9ecdadc3a7fe6a16eb65b70777ca3aada29efa15bee22af732fb8b763</citedby><cites>FETCH-LOGICAL-c434t-2234665b9ecdadc3a7fe6a16eb65b70777ca3aada29efa15bee22af732fb8b763</cites><orcidid>0000-0001-7349-2841 ; 0000-0002-2832-8900 ; 0000-0003-2331-024X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7446583/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7446583/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,21819,27924,27925,43621,43622,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31992107$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Park, Sung E</creatorcontrib><creatorcontrib>Choi, Dae S</creatorcontrib><creatorcontrib>Baek, Hye J</creatorcontrib><creatorcontrib>Ryu, Kyeong H</creatorcontrib><creatorcontrib>Ha, Ji Y</creatorcontrib><creatorcontrib>Choi, Ho C</creatorcontrib><creatorcontrib>Lee, Sangmin</creatorcontrib><creatorcontrib>Won, Jungho</creatorcontrib><creatorcontrib>Jung, Seunguk</creatorcontrib><title>Emergent carotid artery stenting in patients with acute ischemic stroke due to cervical internal carotid artery steno-occlusive lesion: Comparison of tandem intracranial occlusion and isolated cervical internal carotid artery occlusion</title><title>Interventional neuroradiology</title><addtitle>Interv Neuroradiol</addtitle><description>Purpose
Acute ischemic strokes caused by steno-occlusive lesion of the cervical internal carotid artery are associated with poor clinical outcome. We evaluated the clinical efficacy of emergent carotid artery stenting for the management of these lesions. We compared the clinical outcomes regarding the intracranial lesion, namely tandem occlusions versus isolated cervical internal carotid artery occlusion.
Materials and methods
We retrospectively reviewed patients with acute ischemic stroke who underwent carotid artery stenting for cervical internal carotid artery steno-occlusive lesion between 2011 and 2018. After dividing the patients into two groups according to the presence or absence of intracranial lesions (tandem group and isolated cervical group), we analyzed demographic data, angiographic findings, and clinical outcomes. A modified Rankin Scale score ≤2 was defined as a favorable clinical outcome.
Results
Of 75 patients, 46 patients (61.3%) had tandem lesions, and the remaining 29 had only cervical internal carotid artery steno-occlusive lesion. Successful stenting was performed in all patients with favorable clinical outcomes (64.0%). Successful reperfusion score (thrombolysis in cerebral infarction ≥2 b) was 84.0%; tandem group (76.1%) versus isolated cervical group (96.6%) of cases. Mean modified Rankin Scale score at 90-days was 2.09. The rate of favorable clinical outcome showed no statistically significant difference between the two groups (p = 0.454).
Conclusions
Endovascular treatment in patients with acute ischemic stroke due to cervical internal carotid artery steno-occlusive lesion is a technically feasible and clinically effective intervention regardless of intracranial occlusion. Therefore, we recommend endovascular treatment regardless of the presence of concomitant intracranial artery occlusion for patients with acute ischemic stroke caused by cervical internal carotid artery steno-occlusive lesion.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Carotid Artery Stenting</subject><subject>Carotid Artery, Internal</subject><subject>Carotid Stenosis - complications</subject><subject>Carotid Stenosis - diagnostic imaging</subject><subject>Carotid Stenosis - surgery</subject><subject>Cerebral Angiography</subject><subject>Female</subject><subject>Humans</subject><subject>Ischemic Stroke - diagnostic imaging</subject><subject>Ischemic Stroke - etiology</subject><subject>Ischemic Stroke - surgery</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Retrospective Studies</subject><subject>Stents</subject><subject>Thrombectomy</subject><subject>Thrombolytic Therapy</subject><subject>Tomography, X-Ray Computed</subject><issn>1591-0199</issn><issn>2385-2011</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkk1v1DAQhi1ERbctd07IRy4p_kjihAMSWpUPqRKX9mxNnMmuS2IvtrOov5k_gaNdVoBAnGzPvO8z49EQ8oKza86Ves2rljPetrxt2lZV1ROyErKpCsE4f0pWS7pY8ufkIsYHxupKtvwZOZc5JjhTK_L9ZsKwQZeogeCT7SmEhOGRxpSD1m2odXQHyeZXpN9s2lIwc0Jqo9niZE0WBv8FaT8jTZ4aDHtrYMy2jHH58heuL7wx4xztHumI0Xr3hq79tINgo3fUDzSB63FaIAFMAGcz6OjJgpzM9f0ICfv_Vzz5rsjZAGPE58fzkty_v7lbfyxuP3_4tH53W5hSlqkQQpZ1XXUtmh56I0ENWAOvsctBxZRSBiRAD6LFAXjVIQoBg5Ji6JpO1fKSvD1wd3M3YW9w-cWod8FOEB61B6t_zzi71Ru_16os66qRGfDqCAj-64wx6SmPG8cRHPo56txgI2RdKpal7CA1wccYcDiV4UwvO6L_3JFseflreyfDz6XIguIgiLBB_eDnZarx38AfX0HO9w</recordid><startdate>20200801</startdate><enddate>20200801</enddate><creator>Park, Sung E</creator><creator>Choi, Dae S</creator><creator>Baek, Hye J</creator><creator>Ryu, Kyeong H</creator><creator>Ha, Ji Y</creator><creator>Choi, Ho C</creator><creator>Lee, Sangmin</creator><creator>Won, Jungho</creator><creator>Jung, Seunguk</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-7349-2841</orcidid><orcidid>https://orcid.org/0000-0002-2832-8900</orcidid><orcidid>https://orcid.org/0000-0003-2331-024X</orcidid></search><sort><creationdate>20200801</creationdate><title>Emergent carotid artery stenting in patients with acute ischemic stroke due to cervical internal carotid artery steno-occlusive lesion: Comparison of tandem intracranial occlusion and isolated cervical internal carotid artery occlusion</title><author>Park, Sung E ; Choi, Dae S ; Baek, Hye J ; Ryu, Kyeong H ; Ha, Ji Y ; Choi, Ho C ; Lee, Sangmin ; Won, Jungho ; Jung, Seunguk</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c434t-2234665b9ecdadc3a7fe6a16eb65b70777ca3aada29efa15bee22af732fb8b763</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Carotid Artery Stenting</topic><topic>Carotid Artery, Internal</topic><topic>Carotid Stenosis - complications</topic><topic>Carotid Stenosis - diagnostic imaging</topic><topic>Carotid Stenosis - surgery</topic><topic>Cerebral Angiography</topic><topic>Female</topic><topic>Humans</topic><topic>Ischemic Stroke - diagnostic imaging</topic><topic>Ischemic Stroke - etiology</topic><topic>Ischemic Stroke - surgery</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Retrospective Studies</topic><topic>Stents</topic><topic>Thrombectomy</topic><topic>Thrombolytic Therapy</topic><topic>Tomography, X-Ray Computed</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Park, Sung E</creatorcontrib><creatorcontrib>Choi, Dae S</creatorcontrib><creatorcontrib>Baek, Hye J</creatorcontrib><creatorcontrib>Ryu, Kyeong H</creatorcontrib><creatorcontrib>Ha, Ji Y</creatorcontrib><creatorcontrib>Choi, Ho C</creatorcontrib><creatorcontrib>Lee, Sangmin</creatorcontrib><creatorcontrib>Won, Jungho</creatorcontrib><creatorcontrib>Jung, Seunguk</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Interventional neuroradiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Park, Sung E</au><au>Choi, Dae S</au><au>Baek, Hye J</au><au>Ryu, Kyeong H</au><au>Ha, Ji Y</au><au>Choi, Ho C</au><au>Lee, Sangmin</au><au>Won, Jungho</au><au>Jung, Seunguk</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Emergent carotid artery stenting in patients with acute ischemic stroke due to cervical internal carotid artery steno-occlusive lesion: Comparison of tandem intracranial occlusion and isolated cervical internal carotid artery occlusion</atitle><jtitle>Interventional neuroradiology</jtitle><addtitle>Interv Neuroradiol</addtitle><date>2020-08-01</date><risdate>2020</risdate><volume>26</volume><issue>4</issue><spage>425</spage><epage>432</epage><pages>425-432</pages><issn>1591-0199</issn><eissn>2385-2011</eissn><abstract>Purpose
Acute ischemic strokes caused by steno-occlusive lesion of the cervical internal carotid artery are associated with poor clinical outcome. We evaluated the clinical efficacy of emergent carotid artery stenting for the management of these lesions. We compared the clinical outcomes regarding the intracranial lesion, namely tandem occlusions versus isolated cervical internal carotid artery occlusion.
Materials and methods
We retrospectively reviewed patients with acute ischemic stroke who underwent carotid artery stenting for cervical internal carotid artery steno-occlusive lesion between 2011 and 2018. After dividing the patients into two groups according to the presence or absence of intracranial lesions (tandem group and isolated cervical group), we analyzed demographic data, angiographic findings, and clinical outcomes. A modified Rankin Scale score ≤2 was defined as a favorable clinical outcome.
Results
Of 75 patients, 46 patients (61.3%) had tandem lesions, and the remaining 29 had only cervical internal carotid artery steno-occlusive lesion. Successful stenting was performed in all patients with favorable clinical outcomes (64.0%). Successful reperfusion score (thrombolysis in cerebral infarction ≥2 b) was 84.0%; tandem group (76.1%) versus isolated cervical group (96.6%) of cases. Mean modified Rankin Scale score at 90-days was 2.09. The rate of favorable clinical outcome showed no statistically significant difference between the two groups (p = 0.454).
Conclusions
Endovascular treatment in patients with acute ischemic stroke due to cervical internal carotid artery steno-occlusive lesion is a technically feasible and clinically effective intervention regardless of intracranial occlusion. Therefore, we recommend endovascular treatment regardless of the presence of concomitant intracranial artery occlusion for patients with acute ischemic stroke caused by cervical internal carotid artery steno-occlusive lesion.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>31992107</pmid><doi>10.1177/1591019919899755</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-7349-2841</orcidid><orcidid>https://orcid.org/0000-0002-2832-8900</orcidid><orcidid>https://orcid.org/0000-0003-2331-024X</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Access via SAGE; MEDLINE; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Aged Aged, 80 and over Carotid Artery Stenting Carotid Artery, Internal Carotid Stenosis - complications Carotid Stenosis - diagnostic imaging Carotid Stenosis - surgery Cerebral Angiography Female Humans Ischemic Stroke - diagnostic imaging Ischemic Stroke - etiology Ischemic Stroke - surgery Magnetic Resonance Imaging Male Middle Aged Retrospective Studies Stents Thrombectomy Thrombolytic Therapy Tomography, X-Ray Computed |
| title | Emergent carotid artery stenting in patients with acute ischemic stroke due to cervical internal carotid artery steno-occlusive lesion: Comparison of tandem intracranial occlusion and isolated cervical internal carotid artery occlusion |
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