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Published on: May 14, 2013
Mechanical thrombectomy for symptomatic stent thrombosis after carotid artery stenting
You-Min Fan1, Han-Yang Liu2, Yu-Yang Xue3
1Department of Neurology, Xuzhou Municipal First People's Hospital, Xuzhou, China.
Insights
Mechanical thrombectomy effectively revascularized carotid stent thrombosis (CST), leading to good outcomes. This treatment is safe and effective for patients experiencing CST after carotid artery stenting (CAS).
Area of Science:
- Vascular Surgery
- Neurology
- Interventional Cardiology
Background:
- Carotid stent thrombosis (CST) lacks a consensus treatment approach.
- Mechanical thrombectomy is explored as a revascularization strategy for CST.
Purpose of the Study:
- To describe the experience with mechanical thrombectomy for carotid stent thrombosis (CST).
- To evaluate the safety and efficacy of mechanical thrombectomy in treating CST.
Main Methods:
- Retrospective study of patients undergoing mechanical thrombectomy for CST.
- Data collected included procedure outcomes, complications, and clinical/imaging follow-up.
- Study conducted at Xuzhou Municipal First People's Hospital and Xuzhou Central Hospital (Jan 2020 - Nov 2022).
Main Results:
- Six patients with CST after carotid artery stenting (CAS) were included.
- Successful mechanical thrombectomy was achieved in all patients.
- No periprocedural deaths occurred, with modified Rankin Scale (mRS) scores of 0-2 at 3 months, indicating neurological recovery.
Conclusions:
- Mechanical thrombectomy for symptomatic CST yielded satisfactory clinical outcomes.
- The procedure demonstrated safety and effectiveness.
- Further prospective and randomized studies are recommended to confirm these findings.
Background:
As there is still no consensus on the treatment of carotid stent thrombosis (CST), we would like to describe our experience with the revascularization of CST by mechanical thrombectomy.
Methods:
We retrospectively studied patients who underwent mechanical thrombectomy after CST at Xuzhou Municipal First People's Hospital and Xuzhou Central Hospital between January 2020 and November 2022. The results of the procedures, complications, and clinical and imaging follow-up were recorded.
Results:
A total of six patients were included in this study. The stenosis grade before stent implantation was ≥85% in all patients, and the stenosis length ranged from 7 to 20 mm. Patients experienced CST within 6 days to 45 months after carotid artery stenting (CAS); the median admission on the National Institutes of Health Stroke Scale (NIHSS) at CST was 12 (range 8-25). Mechanical thrombectomy was successfully performed in all patients. There was no periprocedural death, and the modified Rankin Scale (mRS) at the 3-month follow-up was 0-2. All patients showed recovery from their neurological deficits.
Conclusion:
The treatment of symptomatic CST with mechanical thrombectomy resulted in satisfactory clinical outcomes. This regimen could be effective and safe, and future prospective and randomized studies are warranted.
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