title: Emergent Recanalization with Stenting for Acute Stroke due to Athero-Thrombotic Occlusion of the Cervical Internal Carotid Artery : A Single Center Experience.
abstract: OBJECTIVE
  The purpose of this study is to demonstrate the technical feasibility and clinical efficacy of emergent carotid angioplasty and stenting (CAS) for acute stroke due to athero-thrombotic occlusion of the cervical internal carotid artery (ICA).
  
  
  METHODS
  Review of medical records identified 17 patients who underwent emergent CAS for treatment of athero-thrombotic occlusion of the cervical ICA with acute stroke between 2009 and 2013. Eleven patients (64.7%) presented with concomitant intracranial artery occlusion, which was treated primarily by mechanical thrombectomy after CAS.
  
  
  RESULTS
  Successful revascularization of the cervical ICA with emergent CAS was achieved in all patients. After CAS, intracranial recanalization with Thrombolysis in Cerebral Infarction ≥2b flow was achieved in four of the 11 patients (36.4%). The overall recanalization rate (cervical ICA and intracranial artery) was 10 of 17 patients (58.8%). Symptomatic intracranial hemorrhage occurred in two patients (11.8%), resulting in death. Ten patients (58.8%) showed improvement (decrease in NIHSS score of ≥4 points) at seven days after recanalization. Nine patients (52.9%) showed a favorable outcome (mRS ≤2) at the last follow-up. A favorable outcome (mRS ≤2) was obtained in four of the six patients with isolated cervical ICA occlusion (4/6, 66.7%) and five of 11 patients with intracranial tandem occlusion (5/11, 45.5%).
  
  
  CONCLUSIONS
  Emergent CAS for acute stroke due to athero-thrombotic occusion of the cervical ICA showed a good technical feasibility and favorable clinical outcome.
authors.affiliation: Department of Neurosurgery, Medical Research Institute, Pusan National University Hospital, Busan, Korea.
authors.forename: Jae Young
authors.initials: JY
authors.lastname: Choi
authors.affiliation: Department of Neurosurgery, Medical Research Institute, Pusan National University Hospital, Busan, Korea.
authors.forename: Jae Il
authors.initials: JI
authors.lastname: Lee
authors.affiliation: Department of Diagnostic Radiology, Medical Research Institute, Pusan National University Hospital, Busan, Korea.
authors.forename: Tae Hong
authors.initials: TH
authors.lastname: Lee
authors.affiliation: Department of Neurology, Medical Research Institute, Pusan National University Hospital, Busan, Korea.
authors.forename: Sang Min
authors.initials: SM
authors.lastname: Sung
authors.affiliation: Department of Neurology, Medical Research Institute, Pusan National University Hospital, Busan, Korea.
authors.forename: Han Jin
authors.initials: HJ
authors.lastname: Cho
authors.affiliation: Department of Neurosurgery, Medical Research Institute, Pusan National University Hospital, Busan, Korea.
authors.forename: Jun Kyeung
authors.initials: JK
authors.lastname: Ko
keywords: Carotid occlusion; Carotid stent; Stroke; Thrombolysis