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Abstract Details

A Comparison Of Primary Angioplasty versus Angioplasty with Stent Placement for Treatment of Internal Carotid Artery Occlusion in Acute Ischemic Stroke Settings
Cerebrovascular Disease and Interventional Neurology
P4 - Poster Session 4 (8:00 AM-9:00 AM)
13-006
To compare the outcomes of primary angioplasty with angioplasty and stent placement in ICA occlusion performed in patients with acute ischemic stroke.

There is controversy whether internal carotid artery (ICA) occlusion should be treated with primary angioplasty or angioplasty with stent placement in an acute ischemic stroke setting.

We analyzed all ICA occlusions who were treated using primary angioplasty or angioplasty with stent placement in acute ischemic stroke patients in the last 5 years. We compared the outcome in each group in form of recanalization measured by TICI (Thrombolysis In Cerebral Infarction) grading scheme, mRS (modified Rankin Score 0-90 days of stroke), intracranial hemorrhages, and death within 30 days of procedure.
A total of 23 of 531 patients with acute ischemic stroke underwent primary angioplasty (n=9) and angioplasty with stent placement (n=14). TICI 2b-3 flow was achieved in 4 and 8 of patients who underwent primary angioplasty and angioplasty with stent placement, respectively. Intravenous antiplatelet agents were used in none of the patients who underwent primary angioplasty and in 9 who underwent carotid angioplasty with stent placement. Any intracranial hemorrhage was seen in 3 and 3 of patients who underwent primary angioplasty and angioplasty with stent placement, respectively. Reocclusion was seen in 1 and 1 of patients who underwent primary angioplasty and angioplasty with stent placement, respectively. 3 patients who underwent angioplasty with stent placement and 0 patient who underwent primary angioplasty died within 30 days. A mRS of 0-1 was seen in 3 and 2 of patients who underwent primary angioplasty and angioplasty with stent placement, respectively.

Compared with primary angioplasty, angioplasty with stent placement in an acute ischemic stroke setting was associated with high use of intravenous antiplatelet agents without a clear benefit on outcomes in patients with ICA occlusion.

 
Authors/Disclosures
Sachin M. Bhagavan, MD
PRESENTER 		Dr. Bhagavan has nothing to disclose.
Nitish Kumar, MD Dr. Kumar has nothing to disclose.
No disclosure on file
Muhammad F. Ishfaq, MD Dr. Ishfaq has nothing to disclose.
Brandi R. French, MD (University of Missouri) Dr. French has nothing to disclose.
Camilo R. Gomez, MD, FAAN (University of Missouri) Dr. Gomez has nothing to disclose.
Farhan Siddiq, MD Dr. Siddiq has nothing to disclose.
Hamza I. Maqsood, MD (Dept of Neurology) Dr. Qureshi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for AstraZeneca.