Prognostic Factors for Neurologic Outcome after Endovascular Revascularization of Acute Symptomatic Occlusion of the Internal Carotid Artery

Abstract

BACKGROUND AND PURPOSE: Management of acute symptomatic internal carotid artery (ICA) occlusion remains controversial. We evaluated outcome predictors of a good recovery in patients with acute symptomatic ICA occlusion.

Endovascular Management of Tandem Occlusion Stroke Related to Internal Carotid Artery Dissection Using a Distal to Proximal Approach: Insight from the RECOST Study

“…The particular, but not rare, tandem occlusion stroke subtype is still poorly explored. Despite promising results reported in the literature, [13][14][15][16][17][18][19][20][21][22] most of the larger trials available on thrombectomy previously cited [23][24][25] excluded ICD.…”

The Outcome and Efficacy of Recanalization in Patients with Acute Internal Carotid Artery Occlusion

“…The more favorable outcome may be related to good collateral circulation and small ischemic core or large penumbra lesion, because retrograde ICA filling, ophthalmic collaterals, or leptomeningeal collaterals are related to better short-term outcomes. 22,29,30 Assessment of occlusion level based on the segmental ICA anatomy as in our study could provide better anatomic confinement and allows the application of proximal and/or distal protection with flow arrest, which subsequently could play a role in improving the recanalization rate and resulting in good clinical outcome.…”

“…Although there are few large series of recanalization for patients with acute ICA occlusion, our results showed the possibility of an improved recanalization rate and good outcome among these patients. 22 Although the natural history of acute stroke with a pro- gressive or fluctuating symptom pattern or perfusion abnormality in patients with low NIHSS is not completely known, recanalization may be warranted because mild or improving stroke may have poor short-term outcomes, 27 and acute ischemic stroke from occlusion of the ICA is one of the most devastating forms of acute ischemia, with only 2%-30% of patients achieving good recovery. 28 Good outcome was related to initial patient status, postprocedural TICI grade, occlusion type, and occlusion level.…”

“…18 The procedural details were the same as we had described previously, except that a 9F sheath was used for the proximal protection balloon catheter. 15,[18][19][20][21][22][23] Protective flow arrest methods included proximal balloon protection with or without distal balloon protection or manual neck compression. The distal balloon was introduced through a 4F catheter or the occluded segment after application of the proximal balloon.…”

Landmark-Wire Technique of Symptomatic Subclavian Artery Occlusion

“…Dual antiplatelet medication (100 mg aspirin and 75 mg clopidogrel) was administered at least three days prior to the procedure in all patients [5][6][7][8] . All procedures were performed under local neuroleptic anesthesia.…”