Emergent Carotid Stenting During Endovascular Therapy for Isolated Cervical Internal Carotid Artery Occlusion

Christoph RIEGLER; João Pedro MARTO; Pimrapat GEBERT; Tilman REIFF; Marek SYKORA; Marcin WIĄCEK; David PAKIZER; André ARAÚJO; Adrien ter SCHIPHORST; João André SOUSA; Arno REICH; Belen Flores PINA; Lukas MAYER-SUESS; Cristina HOBEANU; Marialuisa ZEDDE; João Nuno RAMOS; Georgios TSIVGOULIS; Pedro CASTRO; Sven POLI; José Nuno ALVES; Anne DUSART; Blanca FUENTES; Herbert Tejada MEZA; Jelle DEMEESTERE; Susanne WEGENER; Lars KELLERT; Patricia CALLEJA; Cristina PANEA; Christoph VOLLMUTH; Liliana PEREIRA; Ronen R LEKER; Timo UPHAUS; Andrea ZINI; Henrik GENSICKE; Gauthier DULOQUIN; Taraneh EBRAHIMI; Alexander SALERNO; Cristina TIU; Thanh N NGUYEN; Sebastian GARCÍA-MADRONA; Marta BILIK; Shadi YAGHI; Halina SIENKIEWICZ-JAROSZ; Michał KARLIŃSKI; Stefan KREBS; Eva HURTÍKOVÁ; Nathalia FERREIRA; João SARGENTO-FREITAS; João PINHO; Isabel Rodriguez CAAMAÑO; Elke Ruth GIZEWSKI; Pierre SENERS; Rosario PASCARELLA; Klearchos PSYCHOGIOS; Alexandra Gomez EXPOSITO; Sara GOMES; Flavio BELLANTE; Jorge RODRÍGUEZ-PARDO; Mario Bautista LACAMBRA; Robin LEMMENS; Corinne INAUEN; Johannes WISCHMANN; Fernando OSTOS; Vlad TIU; Karl Georg HAEUSLER; Miguel RODRIGUES; Issa METANIS; Marianne HAHN; Maria Maddalena VIOLA; Simon TRUESSEL; Yannick BEJOT; Louisa NITSCH; Davide STRAMBO; Elena Oana TERECOASA; Mohamad ABDALKADER; Alicia De FELIPE; Farhan KHAN; Caroline ARQUIZAN; Manuel RIBEIRO; Martin ROUBEC; Izabella TOMASZEWSKA-LAMPART; Julia FERRARI; Peter RINGLEB; Christian H NOLTE

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Emergent Carotid Stenting During Endovascular Therapy for Isolated Cervical Internal Carotid Artery Occlusion

Author: Christoph RIEGLER ; João Pedro MARTO ; Pimrapat GEBERT ; Tilman REIFF ; Marek SYKORA ; Marcin WIĄCEK ; David PAKIZER ; André ARAÚJO ; Adrien ter SCHIPHORST ; João André SOUSA ; Arno REICH ; Belen Flores PINA ; Lukas MAYER-SUESS ; Cristina HOBEANU ; Marialuisa ZEDDE ; João Nuno RAMOS ; Georgios TSIVGOULIS ; Pedro CASTRO ; Sven POLI ; José Nuno ALVES ; Anne DUSART ; Blanca FUENTES ; Herbert Tejada MEZA ; Jelle DEMEESTERE ; Susanne WEGENER ; Lars KELLERT ; Patricia CALLEJA ; Cristina PANEA ; Christoph VOLLMUTH ; Liliana PEREIRA ; Ronen R. LEKER ; Timo UPHAUS ; Andrea ZINI ; Henrik GENSICKE ; Gauthier DULOQUIN ; Taraneh EBRAHIMI ; Alexander SALERNO ; Cristina TIU ; Thanh N. NGUYEN ; Sebastian GARCÍA-MADRONA ; Marta BILIK ; Shadi YAGHI ; Halina SIENKIEWICZ-JAROSZ ; Michał KARLIŃSKI ; Stefan KREBS ; Eva HURTÍKOVÁ ; Nathalia FERREIRA ; João SARGENTO-FREITAS ; João PINHO ; Isabel Rodriguez CAAMAÑO ; Elke Ruth GIZEWSKI ; Pierre SENERS ; Rosario PASCARELLA ; Klearchos PSYCHOGIOS ; Alexandra Gomez EXPOSITO ; Sara GOMES ; Flavio BELLANTE ; Jorge RODRÍGUEZ-PARDO ; Mario Bautista LACAMBRA ; Robin LEMMENS ; Corinne INAUEN ; Johannes WISCHMANN ; Fernando OSTOS ; Vlad TIU ; Karl Georg HAEUSLER ; Miguel RODRIGUES ; Issa METANIS ; Marianne HAHN ; Maria Maddalena VIOLA ; Simon TRUESSEL ; Yannick BEJOT ; Louisa NITSCH ; Davide STRAMBO ; Elena Oana TERECOASA ; Mohamad ABDALKADER ; Alicia De FELIPE ; Farhan KHAN ; Caroline ARQUIZAN ; Manuel RIBEIRO ; Martin ROUBEC ; Izabella TOMASZEWSKA-LAMPART ; Julia FERRARI ; Peter RINGLEB ; Christian H. NOLTE
Publication Type:Original Article
From:Journal of Stroke 2026;28(1):160-171
CountryRepublic of Korea
Language:English
Abstract: Background:and Purpose In patients with ischemic stroke and isolated cervical internal carotid artery occlusion (c-ICA-O), endovascular therapy (EVT) can improve cerebral perfusion. To maintain vessel patency, EVT is frequently combined with carotid artery stenting (CAS). We assessed the efficacy and safety of emergent CAS during EVT for isolated c-ICA-O.
Methods:This retrospective multinational cohort study (42 centers) included consecutive patients who underwent EVT for isolated c-ICA-O within 24 hours from the time last seen well. Patients who underwent emergent CAS were compared with those who did not. Co-primary outcomes were c-ICA vessel patency and symptomatic intracerebral hemorrhage (sICH) 24 hours post-EVT. Secondary outcomes included any intracerebral hemorrhage (ICH) at 24 hours and disability at 3 months (modified Rankin Scale [mRS] shift). Outcomes were adjusted using inverse probability of treatment weighting.
Results:Of 317 patients (mean age, 68.6 years [standard deviation, 12.9]; median National Institutes of Health Stroke Scale 11 [interquartile range, 6–17]; 26.8% female), 219 (69.1%) underwent CAS, whereas 98 (30.9%) did not. At 24 hours, vessel patency was more common after CAS (83.5% vs. 40.7%; adjusted odds ratio [aOR], 9.45; 95% confidence interval [CI], 4.91–18.17); sICH rates did not differ (2.3% vs. 3.1%; aOR, 0.92; 95% CI, 0.18–4.73). Any ICH was more common after CAS (19.3% vs. 9.3%; aOR, 2.50; 95% CI, 1.12–5.60). CAS was not associated with mRS at 3 months (adjusted common odds ratio, 0.98; 95% CI, 0.62–1.56).
Conclusions:In patients undergoing EVT for isolated c-ICA-O, emergent CAS was technically effective and reasonably safe. More frequent vessel patency in patients who underwent CAS did not translate into improved functional outcome at 3 months.