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Direct Stenting of Intracranial Atherosclerosis-related Acute Large Vessel Occlusion.

Authors :
Kim, Joong-Goo
Suh, Dae Chul
Song, Yunsun
Choi, Jay Chol
Lee, Deok Hee
Source :
Clinical Neuroradiology; Sep2021, Vol. 31 Issue 3, p833-841, 9p
Publication Year :
2021

Abstract

Purpose: Endovascular reperfusion therapy (ERT) in patients with intracranial atherosclerosis (ICAS)-related acute large vessel occlusion (ALVO) may require different strategies based on the underlying culprit plaque lesion. This study investigated the effectiveness and safety of direct stent placement in ICAS-related ALVO compared with initially attempted mechanical thrombectomy (MT) with or without rescue treatment. Methods: Direct stenting for ICAS-related ALVO was performed in 30 consecutive patients between January 1, 2012, and December 31, 2018. As a control for comparison, MT with or without rescue stenting for patients with ICAS-related ALVO was performed in 73 consecutive patients during the same period. Clinical outcomes were assessed by measuring modified Rankin Scale (mRS) at 90 days. Results: Patients who underwent direct stenting and those who underwent MT with or without rescue stenting showed no significant differences in baseline characteristics. There was a higher proportion of patients with mRS 0–2 at 90 days in the direct stenting group than in the MT with or without rescue stenting group [24 (80.0%) vs. 34 (46.6%); p = 0.004]. Successful recanalization to modified thrombolysis in cerebral infarction category 2b or 3 was achieved in 93.3% of patients who underwent direct stenting, and in 90.4% of patients who underwent MT with or without rescue stenting. Conclusion: Direct stenting is an effective and safe option for ICAS-related ALVO. Further studies are needed to confirm that endovascular treatments are effective and safe in patients with ALVO and underlying ICAS. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
18691439
Volume :
31
Issue :
3
Database :
Complementary Index
Journal :
Clinical Neuroradiology
Publication Type :
Academic Journal
Accession number :
152624115
Full Text :
https://doi.org/10.1007/s00062-020-00934-x