Icad stroke series#
Further evaluation in larger series is warranted.Ĭlosed-cell stent Internal carotid artery dissection Ischemic stroke Stent thrombectomy Stent-assisted revascularization.Ĭopyright © 2015 Elsevier Ltd. Crossing the dissected segment remains the most important limiting factor in achieving successful ICA recanalization. However, unlike extracranial carotid disease, the risk of recurrent stroke in patients with. VW-MRI at one week, showing an eccentric enhancing ICAD of the left MCA (B), there is an MCA preocclusive stenosis on 3D Time-of-flight (C, arrowhead). ICAD is as common a cause of stroke as extracranial carotid disease. Our preliminary data on this selected subgroup of patients suggest the presented approach is safe, feasible in a significant proportion of patients, and efficacious in achieving arterial recanalization and improving patient outcome. There is restricted water diffusion on DWI of the left MCA territory (A). No arterial dissection, arterial rupture or accidental stent detachment occurred, and there was no intracerebral hemorrhage or hemorrhagic transformation. In one patient, attempts to microcatheterize the true arterial lumen failed and thrombectomy was therefore not feasible. Revascularization of the extracranial carotid dissection and stent thrombectomy were achieved in 5/6 patients, resulting in complete recanalization (Thrombolysis in Myocardial Infarction flow grade 3 in a mean 2.7hours), and modified Rankin Scale score 0-2 at 90 day follow-up. INTRODUCTION Intracranial atherosclerotic disease (ICAD) is a major subtype of ischemic stroke and represents the most common cause of stroke in the world.1. Six patients met inclusion criteria (National Institutes of Health Stroke Scale score 12-24, time from symptom onset 2-8hours). The endovascular procedure for carotid artery revascularization and intracranial stent thrombectomy is described. We reviewed data from three randomized controlled studies that published data comparing intracranial stenting vs. ICAD continues to be a disease without an effective method of reducing the risk of recurrent stroke and death, even with aggressive, highly monitored medical treatment. We will discuss the relevant technical factors that. Clinical, imaging, and procedure data were collected retrospectively under Institutional Review Board approval. Intracranial atherosclerotic disease (ICAD) is considered a major cause of recurrent cerebrovascular events. histologic progression of ICAD, and the various mecha- nisms by which it can result in ischemic stroke. Consecutive anterior circulation acute stroke patients meeting Medical Center criteria for endovascular management of ICAD from June 2011 to June 2015 were included. We present our recent experience in the endovascular management of occlusive ICAD and major intracranial occlusion. Intracranial atherosclerotic disease (ICAD) accounts for 10-15 of. Reports on the management of this entity are limited. Ischemic stroke is a major cause of morbidity and mortality, incurring significant cost. Internal carotid artery dissection (ICAD) with concomitant occlusive intracranial large artery emboli is an infrequent cause of acute stroke, with poor response to intravenous thrombolysis.
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