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

2. 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 in Acute Stroke Treatment (TOAST). Neurology 1999

3. 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

5. 15 patients
4 patients

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

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

8. Stenting in acute ICA occlusion
Hemiplegia
since 3 hours
Neuroradiology Homburg

9. Stentimplantation bei akutem ACI Verschluß
Neuroradiology Homburg

10. Neuroradiology Homburg

11. Stenting in acute ICA occlusion
Neuroradiology Homburg

12. Stenting in acute ICA occlusion
Neuroradiology Homburg

13. Stentimplantation bei akutem ACI Verschluß
Neuroradiology Homburg

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

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

16. Results Intracranial recanalization 8/14 (54%)

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

18. 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%)