How do you decide on the timing of carotid stenting after thrombectomy for an intracranial large vessel occlusion with ipsilateral carotid stenosis?
There are ongoing randomized trials that are attempting to tackle this question. So, a data-driven status will be available soon. In the meantime, clinical considerations apply:
- Sometimes one has to stent to gain access to the intracranial circulation, perhaps due to a very tight extracranial carot...
I think this depends on several factors. If the stenosis is critical or if there is an associated local thrombus, emergent angioplasty, and stenting are justified, but it requires dual antiplatelet therapy. If the patient has had a thrombolytic, this has some risk. Patient risk factors ...
This is a complex question, and the optimal approach depends on the underlying etiology of the extracranial stenosis. For example, in cases of tandem LVO with ICA dissection and flow-limiting stenosis, stenting may be considered to stabilize the dissection and prevent further propagation. On the oth...