CAS in acute stroke C. Roth‡, P. Papanagiotou‡, S.Walter@, A. Haass@ M. Politi‡, K. Fassbender@, W. Reith‡ Department of diagnostic.

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Presentation transcript:

CAS in acute stroke C. Roth‡, P. Papanagiotou‡, S.Walter@, A. Haass@ M. Politi‡, K. Fassbender@, W. Reith‡ Department of diagnostic and interventional Neuroradiology‡ Department of Neurology@ Saarland University Hospital, Homburg, Germany

Acute ICA occlusion High disability rate 40-69% mortality 16-55% Favourable clinical outcome 2-12% Adams HP et al. Antithrombotic treatment of ischemic stroke among patients with occlusion or severe stenosis of the internal carotid artery: a report of the Trial of Org 10172 in Acute Stroke Treatment (TOAST). Neurology 1999

Acute ICA occlusion 3 patients group Moderate symptoms fluctuating symptoms Severe acute symptoms Papanagiotou P, Roth C, Reith W et al. Carotid artery stenting for acute stroke. Radiologe 2009

15 patients 4 patients

Patients Acute ICA occlusion Symptom onset < 6 hours NIHSS > 10

Patients collective 17 patients 55-78 years 14 male - 3 female

Stenting in acute ICA occlusion Hemiplegia since 3 hours Neuroradiology Homburg

Stentimplantation bei akutem ACI Verschluß Neuroradiology Homburg

Neuroradiology Homburg

Stenting in acute ICA occlusion Neuroradiology Homburg

Stenting in acute ICA occlusion Neuroradiology Homburg

Stentimplantation bei akutem ACI Verschluß Neuroradiology Homburg

Results Recanalization of ICA in 16/17 (94%) 2 cases proximal protection (NPS) 10 Wallstent - 6 Zilver

Results 14/16 (87.5%) additional intracranial occlusion 2 intracranial ICA 12 MCA ia lysis (4), Penumbra (7), Solitaire (3)

Results Intracranial recanalization 8/14 (54%)

Results mRS 0-2 90 days 7/17 (41.1%) mortality 3/17 (17.6%) Symptomatic ICH 2/17 (11.7%)

Rekanalisierung ACI Intrakranielle Rekanalisierung mRS 0-2 90 Tage Blutung 15/15 (100%) 6/10 (60%) 5/15 (33%) 1/15 (6%) 11/15 (73.3%) 21/24 (84%) 11/21 (54%) 14/25 (56%) 2/25 (8%) 11/24 (45%) Carotid artery stenting in acute stroke Papanagiotou P, Roth C, Reith W et al. 16/17 (94%) 8/14 (54%) 7/17 (41%) 2/17 (11%) 10/17 (58%)