Cor Vasa 2016, 58(2):e204-e206 | DOI: 10.1016/j.crvasa.2016.02.006

Stent or balloon: How to treat proximal internal carotid artery occlusion in the acute phase of ischemic stroke? Results of a short survey

Petr Widimský^a,*, Boris Kožnar^a, Mark Abelson^b, Peter Blaško^g, Peter Lanzer^c, Mikael Mazighiⁱ, Martijn Meuwissen^d, Václav Procházka^e, Horst Sievert^h, Joost de Vries^j, L. Nelson Hopkins^f

^a Kardiocentrum 3. lékařské fakulty Univerzity Karlovy a Fakultní nemocnice Královské Vinohrady, Praha, Česká republika

^b Vergelegen Medi Clinic, Somerset West and Groote Schuur Hospital, University of Cape Town, South Africa

^c Gesundheitszentrum Bitterfeld-Wolfen, Germany

^d Amphia Ziekenhuis, Breda, The Netherlands

^e Radiodiagnostický ústav, Fakultní nemocnice Ostrava, Ostrava, Česká republika

^f University at Buffalo, United States of America

^g Kardiocentrum Nitra, Nitra, Slovenská republika

^h Cardiology Center, Frankfurt am Main, Germany

ⁱ Hôpital Lariboisière, Paris, France

^j Radboud University, Nijmegen, The Netherlands

This short survey presents authors views on three questions related to endovascular treatment of acute ischemic stroke patients with critical stenosis of proximal internal carotid artery either alone or combined with a more distal intracranial artery occlusion. Approximately 15% of patients with acute stroke undergoing interventional treatment present with this condition. The interventional strategy varies from balloon dilatation followed by mechanical thrombectomy to carotid stenting preceeded or followed by mechanical thrombectomy. Antithrombotic treatment also varies from immediate dual antiplatelet therapy to therapy postponed after control CT excludes hemorhage into the ischemic zone.

Keywords: Acute ischemic stroke; Carotid stenting; Dual antiplatelet therapy; Endovascular intervention; Mechanical thrombectomy

Received: January 26, 2016; Revised: February 13, 2016; Accepted: February 17, 2016; Published: April 1, 2016  Show citation