Carotid stenting in acute ischemic stroke patients with intraluminal thrombus.
BACKGROUND
Carotid stenosis with intraluminal thrombus is associated with a high risk of early recurrent stroke. We evaluated the feasibility and outcome of carotid stenting in acute ischemic stroke patients with carotid stenosis and intraluminal thrombus.


METHODS
Among 295 consecutive acute ischemic stroke patients who were referred for intra-arterial thrombolytic (IAT) therapy, six patients with carotid stenosis and intraluminal thrombus were treated by stent assisted angioplasty. The clinical characteristics, feasibility, and clinical outcomes were assessed.


RESULTS
All patients had severe stenosis of the underlying carotid bulb (mean, 86.8%; range, 71-99%) with adjacent intraluminal thrombus. Stent assisted angioplasty resulted in successful recanalization in all six patients. Thrombus was captured with the filter device in four patients. Three patients with tandem occlusion of the ipsilateral proximal middle cerebral artery were successfully recanalized with intra-arterial urokinase. No patients suffered procedure related complications or symptomatic hemorrhage. Four patients showed good long-term outcome (3 month mRS; 0-2).


CONCLUSIONS
Stent assisted angioplasty is a feasible treatment option for acute ischemic stroke patients caused by carotid stenosis with intraluminal thrombus and may be effective in preventing early recurrent stroke.
Department of Radiology, Yonsei University College of Medicine, 250 Seongsanno, Seoul, 120-752, South Korea.
Tai Hyung
TH
Kwon
Byung Moon
BM
Kim
Hyo Suk
HS
Nam
Young Dae
YD
Kim
Ji Hoe
JH
Heo
Dong Ik
DI
Kim
Dong Joon
DJ
Kim
D000368:Aged; D017130:Angioplasty / Q000379:methods*; D002545:Brain Ischemia / Q000209:etiology / Q000628:therapy*; D002343:Carotid Artery, Internal / Q000473:pathology; D016893:Carotid Stenosis / Q000150:complications / Q000175:diagnosis / Q000473:pathology*; D002533:Cerebral Angiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000473:pathology; D015607:Stents; D020521:Stroke / Q000209:etiology / Q000628:therapy*; D013927:Thrombosis / Q000150:complications / Q000175:diagnosis / Q000473:pathology*; D016896:Treatment Outcome