Abstract Background and aims Optimal timing of carotid revascularization with percutaneous transluminal angioplasty and stenting (PTAS) after acute ischemic stroke (AIS) due to symptomatic carotid stenosis (SCS) remains uncertain. This study aimed to compare the safety and efficacy of early versus delayed PTAS following symptom onset. Methods A retrospective, single-center observational study including consecutive patients with AIS or TIA due to SCS ≥50% treated with PTAS between 2015 and 2025. Patients were categorized into Group A (48 h) and Group B (2–14 days). Efficacy was assessed using the modified Rankin Scale (mRS) at 90 days; safety outcomes included symptomatic intracranial hemorrhage, periprocedural stroke, acute myocardial infarction, and 30- and 90-day mortality. A multivariable binary logistic regression was performed to identify independent predictors of unfavorable functional outcome Results A total of 125 patients were included (Group A: 76; Group B: 49). Baseline clinical and imaging characteristics are shown in Table 1. There were no significant differences in the proportion of patients achieving mRS 0–2 at 90 days or in mortality rates (Table 2). In the adjusted model, higher baseline NIHSS and higher NIHSS at discharge were independently associated with increased odds of unfavorable functional outcome at 90 days, while treatment 48 h versus 48 h was associated with a more than tenfold increase in the odds of poor outcome (Table 3). Conclusions Early PTAS did not worsen functional outcomes or mortality compared with delayed intervention and, after adjustment, earlier treatment and lower NIHSS were associated with better 90-day functional status. Conflict of interest Manuel Chasco: "nothing to disclose" - Julieta Rosales: "nothing to disclose" - Juan Jose Cirio. - "nothing to disclose" - Maria Julieta Russo: "nothing to disclose" - Matias Lopez: "nothing to disclose" - Laura Caballero: "nothing to disclose" - Nicolas Perez: "nothing to disclose" - Ivan Lylyk: "nothing to disclose" - Esteban Scrivano: "nothing to disclose" - Pedro Lylyk: "nothing to disclose". Table 1 - belongs to Results Table 2 - belongs to Conclusions Table 1 - belongs to Conclusions
Chasco et al. (2026) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: