Experience of stenting of the extracranial part of the internal carotid artery in patients with acute ischemic stroke

M. Yu. Volodukhin, I. A. Podshivalov, D. R. Khasanova, R. N. Khairullin
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Abstract

Aim. To present the experience of stenting of the extracranial internal carotid artery (ICA) in case of tandem steno-occlusive carotid lesion in the most acute phase of ischemic stroke.Materials and methods. From December 2018 to December 2021, 29 patients with acute ischemic stroke, because of tandem steno-occlusive lesions of the ICA and intracranial arteries, underwent endovascular surgery to restore cerebral blood flow.Results. Successful restoration of cerebral blood flow (according to the mTICI 2b–3 scale) achieved in 22 (75.9 %) patients. Four (13.8 %) patients had stent thrombosis in the early postoperative period. The incidence of symptomatic hemorrhagic transformation observed in 2 (6.9 %) patients. The frequency of a favorable functional outcome (Rankine 0–2) on the 30th day was 20.7 %, mortality – 24.1 %.Conclusion. Stenting of the extracranial ICA in patients with acute ischemic stroke improves the efficiency of restoration of cerebral blood flow. The use of low doses of glycoprotein receptor blockers prevents stent thrombosis in the early period after implantation and does not increase the incidence of symptomatic hemorrhagic complications.
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急性缺血性脑卒中患者颈内动脉颅外段支架置入术的体会
的目标。目的探讨缺血性脑卒中急性期颈动脉狭窄闭塞并发颈动脉支架置入术的临床经验。材料和方法。2018年12月至2021年12月,29例急性缺血性脑卒中患者因ICA和颅内动脉串联狭窄闭塞病变,行血管内手术恢复脑血流。结果。22例(75.9%)患者成功恢复脑血流(根据mTICI 2b-3量表)。4例(13.8%)患者术后早期出现支架血栓形成。2例(6.9%)患者出现症状性出血转化。第30天功能预后良好(Rankine 0-2)的发生率为20.7%,死亡率为24.1%。结论。急性缺血性脑卒中患者颅内外ICA支架植入术可提高脑血流恢复效率。使用低剂量的糖蛋白受体阻滞剂可以防止支架植入后早期血栓形成,并且不会增加有症状的出血性并发症的发生率。
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