P90 Intracranial balloon-expandable stents as rescue treatment in acute stroke secondary to atherosclerotic stenotic vessel disease: 10-year single center experience. (29th August 2022)

• Record Type: Journal Article
• Authors: Elsheikh, S; Elbaz, A; Taschner, C; Urbach, H; Niesen, W-D
• Is Part Of: Journal of neurointerventional surgery. Volume 14(2022)Supplement 2
• Page Start: A44
• Page End: A44
• Publication Date: 2022-08-29
• Subjects: Nervous system -- Surgery -- Periodicals; Cerebrovascular disease -- Surgery -- Periodicals; 617.48
• DOI: 10.1136/neurintsurg-2022-ESMINT.109
• Languages: English
• ISSNs: 1759-8478

Abstract

Abstract : Introduction: Mechanical thrombectomy in acute stroke secondary to intracranial atherosclerotic stenosis is usually unsuccessful and is associated with a poor clinical outcome. Rescue stent angioplasty may be performed, but there is no consensus about the type of stent or the best intraprocedural antiplatelet regime. Aim: We present our 10-year single center experience. Methods: We collected relevant clinical and outcome data retrospectively. Primary outcome measures: stent reocclusion, symptomatic intracranial hemorrhage (sICH) and modified Rankin Score (mRS) at discharge and 90 days. Results: We included 43 patients. Intraprocedural antiplatelet agents was used: aspirin in 28 patients, clopidogrel in 22 patients and GPIIb/IIIa-inhibitor in three patients. Stent reocclusion was observed in five and sICH in four patients. Clinical outcome at discharge was mRS 0–2 in eight patients and mRS 3–6 in 35 patients. Outcome at 90 days is being collected and will be available for the presentation. Discussion: Following a loading dose of aspirin and/or clopidogrel and applying balloon-expandable stents, we observed a rate of sICH similar to other published research. We observed a high rate of early reocclusion and a low rate of good clinical outcome. This contrasts with other publications reporting on using GPIIb/IIIa-inhibitors before application of self-expandable stents. 1 Conclusions: Emergency application of dual antiplatelet agents and balloon-expandable stents for treatment of acute stroke secondary to intracranial atherosclerotic stenotic disease exhibits a comparably high rate of early reocclusion and low rate of good clinical outcome. References: Stracke CP, Fiehler J, Meyer L, et al . Emergency intracranial stenting in acute stroke: predictors for poor outcome and for complications. J AM Heart Assoc . 2020;9 (5):E012795. DOI:10.1161/JAHA.119.012795 Do you have any conflict of interest to declare? : No