London, United Kingdom 2013 Poster Session Blue Cerebrovasc Dis 2013; 35 (suppl 3)1-854 839 932 Interventional neurology INCIDENCE OF EXTRA CRANIAL AND INTRA-CRANIAL ATHEROSCLEROTIC DIS-EASE IN GENERAL ISCHEMIC STROKE POPULATION IN RURAL SOUTH INDIA – A RETROSPECTIVE STUDY S. VANCHILINGAM1, V. somesh2, V. KARTHIKEYAN3 KSDC HOSPITAL, THANJAVUR, INDIA1, KSDC HOSPITAL, THANJAVUR, INDIA2, KSDC HOSPITAL, THANJAVUR, INDIA3 BACKGROUND: Extra cranial atherosclerotic disease account`s for 30 to 60% of total strokes . The incidence of ICAD in the general ischemic stroke population is around 5 to 10 %. ICAD in asian sub group is around 20 -30% of total strokes . This study was done to find out the incidence of ICAD in patients who had got admitted with ischemic stroke . METHODS: In this retrospective study 198 patients spanning a period of 24 months with symptomatic stroke requiring in patient admission with Doppler/MRA evidence of extra cranial carotid disease were evaluated with cerebral 4 vessel DSA to delineate the incidence and pattern of ICAD . Intra-arterial 4 vessel DSA was done and the angiograms were studied for both extra cranial and intra cranial dis-ease in both the anterior and posterior circulation . RESULTS: A total of 198 patients were studied with 4 vessel DSA , Carotid artery disease both symptomatic and asymptomatic stenosis was seen in 173 patients. Extra cranial disease alone was seen in 99 pa-tients . 40 patients had symptomatic stenosis at the carotid bifurcation and 59 patients had asymp-tomatic carotid disease , Extra cranial and intra cranial disease was seen in 50 patients (29%) , the majority of these patients had diffuse intracranial disease in addition to stenosis or narrowing at the carotid bifurcation , Intra cranial atherosclerotic disease was seen exclusively in 24 patients (14%) . Incidence of extra cranial disease was 86% of the patient population and ICAD was seen in 42% of the patient population . Patients with primary ICAD alone were mostly male and were from a younger age group with Alcohol and Tobacco as the major risk factors and from a low socio eco-nomic class . Conclusions : The incidence of ICAD was 42% in stroke population in rural south India and the majority of the patients were young males from a low socio economic class . Significant extra cranial disease in the neck 86 % was the major etiology of anterior circulation stroke . 933 Interventional neurology Comparison between proximal versus distal protection devices in 287 cases of carotid revascu-larization using angioplasty and stenting: periprocedural complications and morbimortality J. Zamarro Parra1, F. Hernández-Fernández2, M. Espinosa de Rueda Ruíz3, B. García-Villalba Navaridas4, G. Parrilla Reverter5, E. Carreón Guarnizo6, A. Morales Ortiz7, M. Garrote8, A. Moreno Diéguez9 Hospital Universitario Virgen de la Arrixaca, Murcia, SPAIN1, Hospital Universitario Virgen de la Arrixaca, Murcia, SPAIN2, Hospital Universitario Virgen de la Arrixaca, Murcia, SPAIN3, Hospi-tal Universitario Virgen de la Arrixaca, Murcia, SPAIN4, Hospital Universitario Virgen de la Arrixa-ca, Murcia, SPAIN5, Hospital Universitario Virgen de la Arrixaca, Murcia, SPAIN6, Hospital Univer-sitario Virgen de la Arrixaca, Murcia, SPAIN7, Hospital Universitario Virgen de la Arrixaca, Murcia, SPAIN8, Hospital Universitario Virgen de la Arrixaca, Murcia, SPAIN9 BACKGROUND: Embolic protection devices may reduce periprocedural thromboembolic complications during carot-id angioplasty and stenting (CAS). Distal and proximal protection systems have been developed for this purpose, nevertheless, direct comparison studies between both techniques are scarcely reported in the medical literature. Positioning and deployment of Distal Protection Devices (DPD) could be technically difficult in cases of vascular tortuousity or vulnerable plaques, whereas Proximal Protec-tion Devices (PPD) do not require crossing the lesion. The objective of this study is to compare the periprocedural complications and morbimortality between 287 consecutive cases of CAS performed with PPD or DPD. PATIENTS AND METHODS: Retrospective analysis of 287 patients treated with CAS at our hospital between January 2006 and March 2012. Periprocedural complications and morbimortality at 30 days, including ischemic stroke or TIA, reperfusion syndrome, myocardial infarction and death were globally registered, and then results in PPD and DPD groups subsequently compared. RESULTS: 208 patients were treated with DPD and 79 with PPD. CAS performed with PPD presented a statis-tically significant higher grade of stenosis than those with DPD (82.5% vs 74.5% p<0.001). Death rates were 1.9% and 1.3%, stroke 4.3% and 3.8%, myocardial infarction 1.4% and 1.3%, global morbimortality 6.2% and 5% (DPD and PPD groups, respectively), all differences non statistically significant. CONCLUSIONS: CAS is a safe procedure to treat carotid disease in our patients. PPD do not associate to a higher risk of periprocedural complications and morbimortality than DPD, despite the higher grade of carotid stenosis in PPD group. This observation may be of interest in the design of future studies with CAS.
Karger_ESC London_2013
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