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KMID : 1155820200150020060
Neurointervention
2020 Volume.15 No. 2 p.60 ~ p.66
Direct Common Carotid Artery Puncture: Rescue Mechanical Thrombectomy Strategy in Acute Ischemic Stroke
Akpinar Cetin Kursad

Gurkas Erdem
Aykac Ozlem
Inanc Yusuf
Giray Semih
Ozdemir Atilla Ozcan
Abstract
Purpose: In a minority of cases, the transfemoral approach cannot be performed due to unfavorable anatomical barriers. In such cases, direct common carotid artery puncture (DCCAP) is an important alternative for rescue mechanical thrombectomy. The purpose of this study was to evaluate the efficacy and safety of DCCAP in patients with an unaccessible femoral route for mechanical thrombectomy.

Materials and Methods: This is a retrospective study using data in the Turkish Interventional Neurology Database recorded between January 2015 and April 2019. Twenty-five acute stroke patients treated with DCCAP were analyzed in this study. Among 25 cases with carotid puncture, 4 cases were excluded due to an aborted thrombectomy attempt resulting from unsuccessful sheath placement.

Results: Patients had a mean age of 69¡¾12 years. The average National Institutes of Health Stroke Scale score was 16¡¾4. Successful revascularization (modified Thrombolysis In Cerebral Infarction 2b-3) rate was 86% (18/21), and 90-day good functional outcome rate (modified Rankin Scale 0?2) was 38% (8/21).

Conclusion: DCCAP is a rescue alternative for patients with unfavorable access via the transfemoral route. Timely switching to DCCAP is crucial in these cases.
KEYWORD
Stroke, Thrombectomy, Treatment outcome, Common carotid artery
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