Aggressive antiplatelets during emergent carotid stenting do not cut stent occlusion or boost 90-day function

In 309 stroke patients undergoing emergent carotid stenting, aggressive antiplatelet therapy (glycoprotein IIb/IIIa inhibitors or clopidogrel) did not significantly reduce early stent occlusion (4.5% vs 2.6%) or improve 90-day functional outcomes compared to conventional therapy…

• Early stent occlusion was low overall (3.2%) and did not differ significantly between aggressive and conventional antiplatelet groups.
• Multivariable analysis showed the unadjusted benefit in 90-day function was no longer significant; recanalization success and IV thrombolysis were the independent predictors of good outcome.
• Procedural duration independently predicted early stent occlusion, suggesting technical factors outweigh antiplatelet intensity.

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