Should We Perform Emergent Carotid Artery Stenting in Acute Stroke?

Clinical Takeaway

: A registry study shows better outcomes with emergent carotid stenting for patients with carotid stenosis who are undergoing acute stroke thrombectomy.

Context

Patients with acute ischemic stroke due to large-vessel occlusion sometimes have a coexisting, moderate-to-severe internal carotid artery (ICA) stenosis or occlusion (i.e., a “tandem lesion”). Whether the extracranial carotid stenosis should be treated at the same time as the thrombectomy is uncertain. These authors conducted a retrospective study of a multicenter registry of thrombectomy procedures performed in Catalonia, Spain, between January 2017 and March 2023. They compared patients who received emergent carotid artery stenting (E-CAS) or did not receive stenting (non-CAS). The primary outcome was a shift on the modified Rankin Scale (mRS) at 90 days. Safety outcomes included hemorrhagic transformation and mortality. Among 578 …

Reviewing Author

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke