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Updated: Jun 7, 2026
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Carotid stenting in acute ischemic stroke patients with intraluminal thrombus
Tai Hyung Kwon1, Byung Moon Kim, Hyo Suk Nam
1Department of Radiology, Yonsei University College of Medicine, 250 Seongsanno, Seoul, 120-752, South Korea.
Insights
Stent-assisted angioplasty is a feasible treatment for acute ischemic stroke caused by carotid stenosis with thrombus. This procedure may effectively prevent early recurrent strokes in high-risk patients.
Area of Science:
- Neurology
- Interventional Cardiology
- Vascular Surgery
Background:
- Carotid stenosis with intraluminal thrombus poses a significant risk for early recurrent stroke.
- Evaluating treatment options for this high-risk patient group is crucial.
Purpose of the Study:
- To assess the feasibility and outcomes of carotid stenting in acute ischemic stroke patients with carotid stenosis and intraluminal thrombus.
- To determine the effectiveness of stent-assisted angioplasty in this specific patient population.
Main Methods:
- Six acute ischemic stroke patients with carotid stenosis and intraluminal thrombus underwent stent-assisted angioplasty.
- Patients were selected from those referred for intra-arterial thrombolytic therapy.
- Clinical characteristics, procedural feasibility, and outcomes were evaluated.
Main Results:
- Successful recanalization was achieved in all six patients with severe carotid stenosis (mean 86.8%).
- Thrombus was captured in four patients using a filter device.
- No procedure-related complications or symptomatic hemorrhages occurred, with four patients showing good long-term outcomes (3-month mRS 0-2).
Conclusions:
- Stent-assisted angioplasty is a feasible and potentially effective treatment for acute ischemic stroke secondary to carotid stenosis with intraluminal thrombus.
- This intervention may reduce the risk of early recurrent stroke in these high-risk individuals.
Introduction:
Carotid stenosis with intraluminal thrombus is associated with a high risk of early recurrent stroke. We evaluated the feasibility and outcome of carotid stenting in acute ischemic stroke patients with carotid stenosis and intraluminal thrombus.
Methods:
Among 295 consecutive acute ischemic stroke patients who were referred for intra-arterial thrombolytic (IAT) therapy, six patients with carotid stenosis and intraluminal thrombus were treated by stent assisted angioplasty. The clinical characteristics, feasibility, and clinical outcomes were assessed.
Results:
All patients had severe stenosis of the underlying carotid bulb (mean, 86.8%; range, 71-99%) with adjacent intraluminal thrombus. Stent assisted angioplasty resulted in successful recanalization in all six patients. Thrombus was captured with the filter device in four patients. Three patients with tandem occlusion of the ipsilateral proximal middle cerebral artery were successfully recanalized with intra-arterial urokinase. No patients suffered procedure related complications or symptomatic hemorrhage. Four patients showed good long-term outcome (3 month mRS; 0-2).
Conclusions:
Stent assisted angioplasty is a feasible treatment option for acute ischemic stroke patients caused by carotid stenosis with intraluminal thrombus and may be effective in preventing early recurrent stroke.
