Abstract
Abstract TP154: Outcomes Of Acute Carotid Stenting With Or Without Intravenous Thrombolysis Among Patients With Acute Tandem Occlusion: Insights From STAR
Stroke, Vol.54(Suppl 1)
02/01/2023
DOI: 10.1161/str.54.suppl_1.tp154
Abstract
Introduction: Emergency carotid artery stenting during mechanical thrombectomy has emerged as an effective emergent treatment for tandem carotid occlusions. Nevertheless, scarce evidence is available about the safety of this procedure in patients who received intravenous tPA before thrombectomy. Herein, we investigate the safety of acute carotid stenting among patients who received intravenous tPA in a large international multicenter registry.
Methods: Patients from the Stroke Thrombectomy and Aneurysm Registry between 2010 and 2022 were analyzed. Only patients with concomitant occlusions of cervical carotid and proximal ipsilateral intracranial segments of the internal carotid or middle cerebral artery were included in the final analyses. Patients were divided into two groups, depending on tPA administration. The primary outcome was 90-day good clinical outcome (mRS 0-2), and the primary safety outcome was symptomatic intracranial hemorrhage. Univariate and multivariate regressions were performed adjusting for variables of clinical importance.
Results: Among 9812 with acute ischemic stroke in the registry, 132 patients had acute tandem occlusion and underwent carotid stenting; of those, 60 patients received IV tPA. Compared to non-intravenous thrombolytics, patients with IV tPA had a higher male prevalence (78.3% Vs 54.4%, P=0.005) and better ASPECT scores (9 Vs 8, P=0.022) with a shorter time from onset to puncture (241 Vs 672 minutes, P<0.001). There was no difference in rates of successful revascularization (94% Vs 95.5%, P=NS), good clinical outcome (50.8% Vs 61.4%, P=NS), symptomatic intracranial hemorrhage (15.3% Vs 14.5%, P=NS) or procedural complications (15% Vs 11.6%, P=NS) between the tPA and non-tPA groups.
Conclusion: The use of IV tPA did not affect the safety or efficacy of emergent carotid stenting in the setting of acute tandem occlusion.
Details
- Title: Subtitle
- Abstract TP154: Outcomes Of Acute Carotid Stenting With Or Without Intravenous Thrombolysis Among Patients With Acute Tandem Occlusion: Insights From STAR
- Creators
- Muhammed Amir Essibayi - Medical University of South CarolinaMohammad Anadani - Medical University of South CarolinaEyad AlmallouhiShadi Yaghi - Brown UniversityOrgest LajthiaIlko Maier - Universitätsmedizin GöttingenPascal M Jabbour - Thomas Jefferson UniversityJoon-Tae Kim - Chonnam National University HospitalStacey Quintero Wolfe - Wake Forest Universityansaar rai - West Virginia UniversityRobert StarkeMarios Psychogios - University of BaselAmir Shaban - University of IowaAdam S Arthur - Semmes Murphey FoundationShinichi Yoshimura - Hyogo Medical UniversityBrian Howard - Emory UniversityAli Alawieh - Emory UniversityIsabel Fragata - Unidade Local de Saúde de São JoséHugo Cuellar - Louisiana State University Health Sciences Center ShreveportAdam PolifkaJustin MascitelliJoshua OsbunCharles Matouk - Yale UniversityMin S ParkMichael LevittTravis DumontRichard WilliamsonDavid Altschul - Montefiore Medical CenterAlejandro M Spiotta - Urbana UniversitySami Al Kasab
- Resource Type
- Abstract
- Publication Details
- Stroke, Vol.54(Suppl 1)
- DOI
- 10.1161/str.54.suppl_1.tp154
- ISSN
- 0039-2499
- eISSN
- 1524-4628
- Publisher
- Ovid Technologies (Wolters Kluwer Health)
- Language
- English
- Date published
- 02/01/2023
- Academic Unit
- Neurology
- Record Identifier
- 9984802501802771
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