Related Experiment Video
Updated: Apr 27, 2026
An In Vivo Assessment of Blood-Brain Barrier Disruption in a Rat Model of Ischemic Stroke
Published on: March 11, 2018
Recanalization therapy for internal carotid artery occlusion presenting as acute ischemic stroke
Jeong-Ho Hong1, Jihoon Kang2, Min Uk Jang3
1Department of Neurology, Keimyung University Dongsan Medical Center, Daegu, Korea.
Insights
Recanalization therapy for internal carotid artery occlusion (ICAO) stroke is common, with endovascular treatment (EVT) showing better outcomes than intravenous thrombolysis (IVT) alone. EVT is effective and safe for acute ischemic stroke patients.
Area of Science:
- Neurology
- Vascular Neurology
- Interventional Neurology
Background:
- Internal carotid artery occlusion (ICAO) accounts for a significant proportion of acute ischemic strokes.
- Understanding the current treatment landscape and outcomes for ICAO is crucial for improving patient care.
Purpose of the Study:
- To describe the current status of recanalization therapy for acute ischemic stroke due to ICAO in Korea.
- To evaluate the clinical outcomes associated with different recanalization strategies.
Main Methods:
- Utilized a nationwide stroke registry database in Korea.
- Identified consecutive ischemic stroke patients with ICAO hospitalized within 12 hours of onset.
- Analyzed data from March 2010 to November 2011.
Main Results:
- ICAO represented 10.6% of acute ischemic strokes within 12 hours.
- 53% of ICAO patients received recanalization therapy, with endovascular treatment (EVT) being more common than intravenous thrombolysis (IVT) alone.
- EVT significantly improved the odds of a favorable outcome compared to IVT, with a successful recanalization rate of 76% and acceptable safety profile.
Conclusions:
- Approximately 10% of acute ischemic strokes in Korea are caused by ICAO.
- Recanalization therapy is administered to about half of ICAO patients, with EVT being a frequently used modality.
- Endovascular treatment demonstrates acceptable effectiveness and safety for ICAO, offering improved outcomes compared to IVT.
Background:
We aimed to describe the current status and clinical outcomes of recanalization therapy for internal carotid artery occlusion (ICAO) presenting as acute ischemic stroke.
Methods:
Using a nationwide stroke registry database in Korea, we identified consecutive ischemic stroke patients with ICAO hospitalized within 12 hours of onset between March 2010 and November 2011.
Results:
ICAO accounted for 10.6% (322 of 3028) of acute ischemic strokes within 12 hours of onset. Among the 322 ICAO patients, 53% underwent recanalization therapy, 41% intravenous thrombolysis (IVT) alone, and 59% endovascular treatment (EVT). Twenty-two percent of those with mild deficits (National Institutes of Health Stroke Scale <4) and 50% of those 80 years of age or more received recanalization therapy. Compared with no treatment, recanalization therapy was not significantly associated with a favorable outcome (3-month modified Rankin scale, 0-2) (adjusted odds ratio [OR], 1.77; 95% confidence interval [CI], .80-3.91; P = .16). However, compared with IVT, EVT significantly improved the odds of favorable outcome (OR, 2.86; 95% CI, 1.19-6.88; P = .02) without significant increase of symptomatic intracranial hemorrhage (OR, 2.18; 95% CI, .42-11.43; P = .36) and 3-month mortality (OR, .53; 95% CI, .23-1.18; P = .12). Successful recanalization rate (Thrombolysis in Cerebral Infarction ≥2a) by EVT was 76%.
Conclusions:
In Korea, one tenth of acute ischemic stroke was caused by ICAO, and about 50% were treated by recanalization therapy. EVT was widely used as a recanalization modality (about 60% of cases) despite lack of evidence. However, its effectiveness and safety were acceptable.
