2025 American Academy of Neurology Abstract Website

Objective:

The purpose of the study was to observe the functional outcome of ischemic stroke patients after carotid stenting without protection device.

Background:

Carotid angioplasty and stenting is a treatment option for ischemic stroke patients who had carotid stenosis. Previous studies showed mixed results about its efficacy and functional outcome.

Design/Methods:

This was a hospital based prospective longitudinal before – after study conducted in the department of neurology, BSMMU. This study evaluated 39 ischemic stroke patients who had significant stenosis in the extracranial portion of internal carotid artery during October 2022 to September 2023. Vascular imaging by any of the modalities like Carotid Doppler, MRA, or cerebral DSA was done and the degree of stenosis was measured by the NASCET formulae. Those patients had > 50% carotid stenosis underwent carotid artery stenting. Then all the patients were followed up by MRI (including DWI sequence) of Brain within 48 hours to see the occurrence of any new DWI lesion.

Results:

Mean age of the respondents were 59.8 ± 9.4 years. Hypertension was found most common among the patients (76.9%) followed by DM (51.3%), Smoking (38.5%), dyslipidemia (38.5%), CKD (12.8%). Before Stenting 97.4% patients had DWI lesion on MRI. Severe carotid stenosis was found among 89.7% patients and 69.2% lesions were ulcerated. Calcification was present in 17.9% lesion and 33.3 % lesions were more than 15 mm in length. Carotid stenting was done in left side in 64.1% of the patients and 35.9 % had right sided carotid stenting without any distal protection device. Before stenting only 9(23.1%) patients had mRS 0-2, whereas one month after stenting 38(97.4%) patients achieved good functional outcome which is statistically significant (p value< 0.001).

Conclusions:

Carotid stenting with or without angioplasty without protection device is a relatively safe procedure with significant good functional outcome in indicated cases