Abstract

Introduction: Acute ischemic stroke caused by large vessel occlusion is a severe condition, especially when multiple lesions result in cerebral vascular occlusion. This study was conducted to evaluate the effectiveness and safety of interventional techniques for extracranial internal carotid artery lesions in patients with acute ischemic stroke due to tandem occlusion.

Methods: This is a prospective, non-randomized study, evaluating patients before and after treatment.

Results: There were no significant differences in the clinical and imaging characteristics between the carotid stenting group and the balloon angioplasty group. The stenting group showed high efficacy in restoring blood flow, with a TICI score ≥ 2b achieved in 94.1% of cases, compared to 90% in the balloon angioplasty group. The NIHSS score improvement from hospital admission to 24 hours post-treatment was 8.5 ± 3.2 in the stenting group, which was not significantly higher than 5.3 ± 6.9 in the balloon angioplasty group. At the 3-month follow-up, 94.1% of patients in the stenting group had a mRS score of 0-2, compared to 50% in the balloon angioplasty group. Both techniques presented a low incidence of complications, with no significant differences between the two groups.

Conclusion: Interventional techniques for extracranial internal carotid artery lesions in patients with acute ischemic stroke due to tandem occlusion yield positive outcomes. However, stenting shows better prognostic results at 3 months compared to simple balloon angioplasty.