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ESOC 2023 | Antithrombotic strategies for emergent carotid stenting during stroke thrombectomy

Raoul Pop, MD, PhD, University Hospitals Strasbourg, University of Strasbourg, Strasbourg, France, discusses antithrombotic strategies during emergent carotid stenting in ischemic stroke patients. Debates remain regarding the management of internal carotid artery (ICA) lesions. While many believe that carotid stent placement at the time of endovascular clot retrieval is preferable when there is tandem occlusion, it has been associated with higher rates of intracerebral hemorrhage and a risk of in-stent thrombosis. Currently there is no prospective data to support emergent carotid stenting, however there is an accumulating body of retrospective evidence supporting emergent stenting to improve recanalization rates and clinical outcomes. Additionally, there is no consensus regarding the optimal antiplatelet regimen for emergent carotid stenting during stroke thrombectomy. Dr Pop has been involved in several retrospective studies which have shown that more intensive periprocedural antiplatelet treatment in the acute phase is associated with improved carotid stent patency, without additional intracranial hemorrhagic transformation. Further prospective research is warranted. This interview took place during the European Stroke Organisation Conference (ESOC) in Munich, Germany.

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