CFITN 2023 Celebrated, Team Releases CRC Voice

Hosted by the Association of Chinese Physicians, the Professional Committee on Neurointervention of the China Medical Association, and the Guangxi Hospital, a subsidiary of the University of China Medical University, Guangzhou will be the location of the 2023 Annual Meeting of the Chinese Medical Association on Neural Intervention and the tenth Chinese Congress on Neurological Intervention. These events will take place from December 1st to December 3rd, 2023. In late 2023, colleagues in the field of neurological interference from across the country will convene in Green City for a three-day academic event, experiencing the vibrancy and liveliness of Nanjing.

Professor Wang Tao of Xuanwu Hospital of Capital Medical University, a member of the CRC team, delivered a keynote speech on "The Evidence-Based Road of Carotid Artery Stenosis Intervention" at the Cerebral Rehabilitation Forum, reviewing and looking forward to the road of carotid artery stenosis interventions.

1) The road to establishing the gold standard of CEA

The VACS, NASCET, and ECST studies have shown that CEA is inferior to drugs for mild symptomatic stenosis (<50%). For symptomatic severe stenosis (70–99%), CEA is superior to drugs For symptomatic moderate stenosis (50–69%) 5-year ipsilateral stroke incidence: 15.7% for CEA, 22.2% for drugs (p = 0.045) The ACAS and ACST studies have shown that for asymptomatic carotid artery stenosis (60–99%), CEA is superior to drugs in terms of long-term outcome. The above establishes CEA as the gold standard for carotid stenosis.

2) CAS Challenges the Path to CEA: The

The CREST and ACT studies showed that the short- and long-term outcomes of CEA and CAS were essentially equivalent. meta-analysis of PD showed that in symptomatic carotid stenosis, CEA was superior to CAS in both the perioperative and overall outcomes. meta-analysis of 8 RCTs of patients with asymptomatic carotid stenosis showed that perioperative stroke or death was less common in CEA than in CAS.

3) TCAR: The Future of Uncoronation

A prospective registry study showed that the rate of perioperative stroke or death was lower in TCAR (1.6%) than in TFCAS (3.1%). For stroke or death within one year, TCAR was significantly better than TFCAS, suggesting that TCAR is sufficiently superior to TFCAS. Another prospective registry study showed that perioperative outcomes were no different from CEA in TCAR patients with worse conditions, and more evidence is needed for TCAR to be comparable to CEA in the future.

Professor Gao Peng of Xuanwu Hospital of Capital Medical University, a member of the CRC team, delivered a keynote speech at the Emergency Embolisation Forum on the topic of "Emergency Embolisation Strategies for Combined ICAD," providing Xuanwu's experience in emergency embolisation of combined ICAD.

(1) ICAS accounts for 1.9%–33% of patients with acute large vessel occlusion treated with thrombolysis.

(2) In China, about 30% of patients treated with thrombolysis have ICAS.

3) In ICAS lesions, stent thrombolysis is often recommended as the treatment of choice. Stent thrombolysis has the following advantages over direct aspiration:.

1. Significantly shorter time from puncture to recanalization.

2. Easier reperfusion. However, acute reocclusion occurs in approximately 70% of patients after stenting.

4) Xuanwu Hospital, like other centres, has similarly found remedial therapy to be safe and effective.

5) Direct remedial therapy is indicated for the following ICAS-LVO: patients with less negative remodelling of the thrombus load or with a lower expected risk.