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CASSH Registry: Rationale and Study Design

Mohamad Ezzeldin1, Ali Kerro2, Ameer E Hassan3

  • 1Department of Neuroendovascular Surgery HCA Houston Healthcare Kingwood Kingwood TX.

Stroke (Hoboken, N.J.)
|January 26, 2026
PubMed

Insights

The Carotid Artery Stenting Outcomes in Comprehensive Stroke Hospitals (CASSH) registry evaluates carotid artery stenting (CAS) outcomes. This study highlights the importance of neurointerventionalist expertise in CAS procedures at stroke centers.

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.
Abstract

Keywords:
carotid artery stenosiscarotid artery stentingcomprehensive stroke centerneuro interventional surgeon

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