Abstract Details

Title Efficacy and Safety of Emergent Carotid Stenting in the Setting of Acute Ischemic Stroke

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) S02 - (-)

Poster/Presentation
Number 002

Objective

Background Strokes secondary to internal carotid artery(ICA)occlusions and preocclusive stenoses respond poorly to intravenous thrombolysis. This study describes the safety and efficacy of emergent carotid stenting with intracranial revascularization in acute ischemic stroke.

Design/Methods This is a retrospective chart review to assess the clinical outcomes of patients who presented to Stony Brook University Hospital over 32 months.Patients presented within 9 hours of acute ischemic stroke secondary to complete or functional occlusion of the cervical ICA with or without intracranial embolic occlusions. Patients underwent emergent carotid stenting followed by pharmacological and/or mechanical revascularization of the intracranial occlusion. Safety(no symptomatic hemorrhages and no post-procedural increase in the NIHSS)and effectiveness(improvement of the NIHSS by [rang]4 points)were assessed.

Results During the observed period,11 patients(6 females&5 males, mean age 65 years) presented to our hospital with acute stroke secondary to complete or functional cervical ICA occlusion with(n=6) or without(n=5) concomitant intracranial ICA and/or MCA occlusion. 5 patients had complete cervical ICA occlusions while 6 had pre-occlusive stenosis. Mean NIHSS score on admission was 15.2(range 8-22). Mean time from symptom onset to intervention was 4 hours 18 minutes. All patients were administered IA abciximab(dose range6-17mg,average 11.4mg) immediately following cervical ICA stenting. With regards to safety, no symptomatic hemorrhages were observed and no increase in their pre-procedural NIHSS was demonstrated. Upon discharge, the mean NIHSS score was 5.09 (range 0-17). Eight patients were discharged to acute rehabilitation facilities and three were discharged home. 10(90.9%)patients demonstrated an improvement in their presenting NIHSS by [rang]4 points demonstrating an acceptable level of efficacy.

Conclusions The present data suggest that emergent carotid artery stenting in the setting acute ischemic stroke may be performed with an acceptable level of safety and efficacy.

Authors/Disclosures
Fawaz Al-Mufti, MD (Westchester Medical Center at New York Medical College) PRESENTER	Dr. Al-Mufti has received personal compensation in the range of $0-$499 for serving as a Consultant for Stryker. Dr. Al-Mufti has received personal compensation in the range of $0-$499 for serving as a Consultant for Cerenovus. Dr. Al-Mufti has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Revalesio .
Candice Perkins, MD (Candice Perkins Md)	No disclosure on file
Imad R. Khan, MD (University of Rochester Medical Center)	The institution of Dr. Khan has received research support from National Institute of Neurological Diseases and Stroke. The institution of Dr. Khan has received research support from National Heart Lung and Blood Institute. The institution of Dr. Khan has received research support from National Institute of Neurological Diseases and Stroke.
	No disclosure on file
	No disclosure on file
Michael S. Okun, MD, FAAN (University of Florida)	Dr. Okun has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for NIH. Dr. Okun has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for Parkinson's Foundation. Dr. Okun has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for JAMA Neurology. Dr. Okun has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for NEJM Journal Watch. The institution of Dr. Okun has received research support from NIH. The institution of Dr. Okun has received research support from Parkinson's Foundation. The institution of Dr. Okun has received research support from Tourette Association of America. The institution of Dr. Okun has received research support from Michael J Fox. Dr. Okun has received publishing royalties from a publication relating to health care.

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