{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T15:24:40Z","timestamp":1794324280614,"version":"4.9.0"},"reference-count":31,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,1]]},"abstract":"\n OBJECTIVE<\/jats:title>\n The impact of extracranial carotid stenosis on interventional revascularization of acute anterior circulation stroke is unknown. The authors examined the effects of high-grade carotid stenosis on the results of endovascular treatment of patients in the Interventional Management of Stroke (IMS)-III trial.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n The 278 patients in the endovascular arm of the IMS-III trial were categorized according to the degree of carotid stenosis as determined by angiography. In comparing patients with severe stenosis or occlusion (\u2265 70%) to those without severe stenosis (< 70%), the authors evaluated the time to endovascular reperfusion, modified Thrombolysis in Cerebrovascular Infarction (mTICI) scores, 24-hour mean infarct volumes, symptomatic intracerebral hemorrhage rates, and modified Rankin Scale (mRS) scores at 90 days.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n Compared with the 249 patients with less than 70% stenosis, patients with severe stenosis (n = 29) were found to have a significantly longer mean time to reperfusion (105.7 vs 77.7 minutes, p = 0.004); differences in mTICI scores, infarct volumes, hemorrhage rates, and mRS scores at 90 days did not reach statistical significance. Multiple regression analysis revealed that severe carotid stenosis (p < 0.0001) and higher baseline National Institutes of Health Stroke Scale (NIHSS) scores (p = 0.004) were associated with an increase in time to reperfusion. Older age (p < 0.0001), higher NIHSS score (p < 0.0001), and the absence of reperfusion (p = 0.001) were associated with worse clinical outcomes.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n Severe ipsilateral ICA stenosis was associated with a significantly longer time to reperfusion in the IMS-III trial. Although these findings may not translate directly to modern devices, this 28-minute delay in reperfusion has significant implications, raising concern over the treatment of tandem ICA stenosis and downstream large-vessel occlusion.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2016.9.jns161044","type":"journal-article","created":{"date-parts":[[2017,2,3]],"date-time":"2017-02-03T09:59:41Z","timestamp":1486115981000},"page":"94-99","source":"Crossref","is-referenced-by-count":9,"title":["Severe carotid stenosis and delay of reperfusion in endovascular stroke treatment: an Interventional Management of Stroke-III study"],"prefix":"10.3171","volume":"128","author":[{"given":"Steven L.","family":"Gogela","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yair M.","family":"Gozal","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas A.","family":"Tomsick","sequence":"additional","affiliation":[{"name":"Radiology, University of Cincinnati College of Medicine;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.","family":"Ringer","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"},{"name":"Comprehensive Stroke Center at the University of Cincinnati Neuroscience Institute;"},{"name":"Mayfield Clinic; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph P.","family":"Broderick","sequence":"additional","affiliation":[{"name":"Neurology and Rehabilitation Medicine, and"},{"name":"Comprehensive Stroke Center at the University of Cincinnati Neuroscience Institute;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pooja","family":"Khatri","sequence":"additional","affiliation":[{"name":"Neurology and Rehabilitation Medicine, and"},{"name":"Comprehensive Stroke Center at the University of Cincinnati Neuroscience Institute;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd A.","family":"Abruzzo","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"},{"name":"Comprehensive Stroke Center at the University of Cincinnati Neuroscience Institute;"},{"name":"Mayfield Clinic; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns161044","series-title":"AJNR Am J Neuroradiol","first-page":"524","article-title":"Complications of endovascular treatment for acute stroke in the SWIFT trial with solitaire and Merci devices","volume":"35","author":"Akins PT,","year":"2014","unstructured":"Akins PT, Amar AP, Pakbaz RS, Fields JD: Complications of endovascular treatment for acute stroke in the SWIFT trial with solitaire and Merci devices. 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