P145 Stent retriever as distal filter for endovascular management of acute atherosclerosis-related carotid occlusions: a novel technique

<h3>Introduction</h3> The endovascular treatment of patients with acute ischemic stroke secondary to atheromatous occlusion of the extracranial internal carotid artery poses a challenge for the operator in cases where there is no intracranial occlusion or it affects a small vessel. This is because there is an increased risk of distal thromboembolic complications during angioplasty of the unstable plaque that has occluded. <h3>Aim of Study</h3> The aim of this study is to demonstrate the efficacy and safety of a new technique used during the endovascular treatment of these patients. <h3>Methods</h3> Retrospective analysis of the outcomes in patients treated with the technique, which involves using a stentretriever positioned in the M1-M2 segments as a distal carotid filter. The pusher wire of the retriever itself serves as a guide for angioplasty balloons. <h3>Results</h3> This study included 18 patients with acute atherosclerosis-related CAO who were treated using the new endovascular approach. It prevents distal embolisms and reduces procedural time compared to conventional methods, as demonstrated by improved intervention times, higher first-pass efficiency, and reduced rates of distal embolism. <h3>Conclusion</h3> This study demonstrates that using a stent retriever as a filter (in conjunction with BGCs) for treating acute atherosclerosis-related carotid artery occlusion is a safer and faster technique with a greater first-pass effect, and prevents distal embolisms compared to conventional techniques.