Timing of dual antiplatelet therapy after emergent carotid artery stenting (eCAS) in acute ischemic stroke: results from the Madrid eCAS multicenter registry (MeCAS)

BACKGROUND: Emergent carotid artery stenting (eCAS) is increasingly used in acute stroke due to tandem occlusion. However, the optimal timing for initiating dual antiplatelet therapy (DAPT) remains unknown. We analyze the effectiveness and safety of early versus delayed initiation of DAPT in a cohort of patients with acute stroke treated with eCAS. METHODS: Multicenter registry of patients treated with eCAS from 2019 to 2023. Main outcomes were stent occlusion/restenosis during follow-up, symptomatic intracranial hemorrhage (sICH) after DAPT, and good functional outcome at 3 months (modified Rankin scale (mRS) 0-2). Two timeframes for early DAPT initiation were considered: