INTRODUCTION: In @entity1 undergoing interventional treatment for @entity64 ( @entity64 ), proximal @entity2791 may hinder access to the @entity432 ( @entity432 ), compromise inflow during the intervention and prolong events leading to cerebral reperfusion. We examined proximal @entity2791 in the Interventional Management of @entity64 (IMS)-III trial, hypothesizing that it would impede successful endovascular therapy for @entity64 and worsen outcomes. METHODS: We reviewed 369 @entity1 from the prospective, randomized IMS-III trial who received both IV rt-PA and intra-arterial treatment for @entity64 . Degree of @entity3538 (EC-ICA) @entity850 was determined by pretreatment digital subtraction angiogram. We compared those with EC-ICA @entity850 <70% vs @entity1 with @entity850 =70%; statistical significance was determined by t test. Outcome measures included mean @entity1188 volume (MIV), mean time to reperfusion, rates of symptomatic @entity1779 (sICH), mean modified Rankin score (mRS) at 90 days, and the percentage of @entity1 with mRS 0 to 2 at 90 days. RESULTS: In comparison with those with =70% @entity850 , @entity1 with <70% @entity850 had a lower mean mRS at 90 days (2.9 vs 3.3, P = .10), greater percentage of mRS 0 to 2 (43.5% vs 34.3%, P = .15), smaller MIV (70.1 vs 87.6 mL, P = .18), shorter mean time to reperfusion (78.7 vs 105.7 minutes, P = .002), and a higher rate of sICH (7.3% vs 2.7%, P = .15). CONCLUSION: In @entity1 receiving combined IV/IA treatment for @entity64 within the IMS-III trial, ipsilateral EC-ICA @entity850 of =70% significantly delayed reperfusion by an average of 26 minutes. This resulted in trends favoring larger @entity1188 volumes with worse clinical outcomes despite a lower rate of sICH. This substantial treatment delay likely stems from a combination of difficult microcatheter access across the @entity850 , the addition of intermediate steps to manage the @entity850 (ie, @entity661 ), and the restrictive effect of the @entity850 on inflow in @entity1 treated by thrombolysis.

160   Carotid Stenosis Significantly Delays Reperfusion During Endovascular Treatment of XXXX in the IMS-III Trial.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity64 :: ('MESH:D020521', 'Disease') :: ['acute ischemic stroke', 'AIS', 'Stroke'] @entity3538 :: ('MESH:D002341', 'Disease') :: ['ipsilateral extracranial internal carotid artery'] @entity2791 :: ('MESH:D012078', 'Disease') :: ['arterial stenosis'] @entity1188 :: ('MESH:D007238', 'Disease') :: ['infarct'] @entity661 :: ('MESH:D054549', 'Disease') :: ['balloon angioplasty'] @entity432 :: ('MESH:D001157', 'Disease') :: ['AOL', 'arterial occlusive lesion'] @entity850 :: ('MESH:D003251', 'Disease') :: ['stenosis'] @entity1779 :: ('MESH:D002543', 'Disease') :: ['intracerebral hemorrhage']
@entity64 :: (MESH:D020521,Disease) :: ['Stroke']
