CASSH Registry: Rationale and Study Design

Area of Science:

• Neurology
• Vascular Surgery
• Interventional Cardiology

Background:

• Carotid artery disease, particularly atherosclerotic stenosis, is a leading cause of stroke.
• Carotid endarterectomy is the traditional treatment, but carotid artery stenting (CAS) is an alternative for high-risk patients.
• Neurointerventional specialists possess crucial skills for CAS, yet are often underrepresented in studies.

Purpose of the Study:

• To investigate outcomes of carotid artery stenting (CAS) performed by neurointerventionalists.
• To address the underrepresentation of neurointerventional expertise in current CAS research.
• To provide comprehensive insights into CAS procedures at comprehensive stroke centers.

Main Methods:

• The CASSH (Carotid Artery Stenting Outcomes in Comprehensive Stroke Hospitals) registry is a multicenter, prospective, observational study.
• Patients with carotid artery stenosis undergoing CAS by neurointerventional physicians are enrolled.
• Data collection includes baseline, procedural, and postoperative clinical and imaging variables.

Main Results:

• Outcomes measured include postoperative symptomatic stroke (hemorrhagic/ischemic), access site complications, in-stent thrombosis, and mortality.
• The registry captures detailed procedural and patient data for comprehensive analysis.
• Results will elucidate complication rates and effectiveness of CAS in a real-world setting.

Conclusions:

• Current literature inadequately represents neurointerventionalists' role and outcomes in CAS.
• The CASSH registry will enhance understanding of CAS management and outcomes.
• Emphasizing neurointerventional expertise in comprehensive stroke centers is key to improving CAS results.