A242 ESMINT clinical survey of carotid artery stenting in patients with atrial fibrillation: preliminary results

<h3>Introduction</h3> Antithrombotic treatment in patients with non-valvular atrial fibrillation (NVAF) undergoing elective carotid artery stenting (CAS) is not well established. Stent placement requires dual antiplatelet therapy to prevent stent-related ischemic events, while NVAF necessitates anticoagulation against stroke occurrence. Therefore, cautious balance between the risk of cerebral ischemia and intracranial hemorrhage is crucial in these patients. <h3>Aim of study</h3> We investigated different antithrombotic management strategies for NVAF patients undergoing CAS. <h3>Method</h3> A 50-question clinical survey is being electronically distributed (February 1 – May 15, 2025) to ESMINT and SNIS members through their society platforms and via the Neuroanalytics &amp; Neurointerventional Consortium (NAN-C). Data will be analyzed with SPSS following CROSS guidelines. <h3>Results</h3> Preliminary data from 105 participants, across 31 countries, show significant practice variation. Key findings include: 61.9% lack a standardised institutional antithrombotic protocol dual antithrombotic treatment (DAT: NOAC/VKA plus one antiplatelet) is preferred over triple antithrombotic treatment (TAT: NOAC/VKA + dual antiplatelet therapy) for both intermediate (64.8%) and high-bleeding risk (79.3%) patients (using HAS-BLED score) 54.3% switch patients from VKA to a NOAC post-CAS (if on VKA before) 69.5% transition to NOAC/VKA monotherapy at 1 year post-intervention <h3>Conclusion</h3> Current practices for antithrombotic management in NVAF patients post-CAS vary widely globally. This survey shows a trend for DAT over TAT, likely driven by concerns about hemorrhagic complications, while aiming to maintain efficacy against ischemic events. Randomized clinical trials are needed to define optimal management strategies for this patient population. <h3>Conflict of Interest</h3> No