Abstract Background and aims The optimal treatment for acute stroke secondary to isolated cervical internal carotid artery occlusion (ICAO) lacks evidence from clinical trials. Our objective was to evaluate the use of reperfusion therapies in patients with this condition. Methods Prospective study of patients with ICAO from the NORDICTUS registry in Spain (11 centers), period 30/11/2017 to 16/01/2023. They were classified according to the therapeutic option endovascular thrombectomy Vs intravenous fibrinolysis (EVT/ IVT) and the severity of the deficit (NIHss admission ≥6). Results Sixty-four patients (median age 73 years) were included: 40 received EVT (10 combined with IVT) and 24 received IVT alone. Patients receiving EVT had a higher deficit than the IVT group (NIHss admission) 18 (12-19) vs. 6.5 (4.25-12), p0.001. Symptomatic bleeding and mortality rates were 6.3% and 20.3%, respectively. The IVT group had a better prognosis (mR ≤2) than the EVT group (62.5% vs. 37.5%; p=0.093). In the analysis according to NIHss ≥6, no differences were found between IVT (n=13) and EVT (n=38) mR ≤2 53.8% vs. 34.2%; OR 1.5 (0.8-3.0), p=0.35. In the EVT group, procedure time (mR≤2: median 40 minutes (30-84) vs mR2: 90 (39-125); p=0.046 and collateral grade were significantly associated with better outcome (grade 50%, mR≤2 60.9%; vs grade 50%, mR≤2 0%; p=0.041). Conclusions In patients with ICAO, medical treatment offers better results than EVT, although patient selection varies depending on the initial severity of the stroke. Procedure time and collateral damage are variables that influence the outcome of EVT. Conflict of interest No author has anything to declare
González-Feito et al. (Fri,) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: