Patients and method: DSA showed ICAO in 9 male patients, aged 57 to 77 years old. Among them, four patients showed recurrent TIA episodes, three showed dizziness with unilateral weakness, one showed unilateral blindness caused by paroxysmal amaurosis, and one showed paresis of left lower limb. Tail-like gradual occlusion occurred in 6 patients and neatly blunt occlusion in 3 patients. Distal carotid varying degrees of progress occurred in 6 patients. Results: Six cases showed recanalization, while another three were not. After 2-year follow-up, seven cases did not show further cardiovascular and cerebrovascular events. Two patients died of heart disease. Conclusion: Hemodynamic analysis is an important part for the operation. Tail-like gradual occlusion and forward or retrograde blood flow developing of the distal carotid artery should serve as strong evidence to choose operation. With regard to ICAO tech- niques, the length of the hard tough thrombosis exceeds the carotid incision by 3 cm, Fogarty catheter was applied to insert into the distal embolization, slowly retraced after filling the balloon, and repeated until blood flows out of the thrombosis. According to the intraoperative angiography, we can decide whether the stent is placed in the distal artery occlusion or not. doi:10.1016/j.jns.2013.07.758 Abstract — WCN 2013 No: 1143 Topic: 3 — Stroke Intra-arterial mechanical procedures in treatment of acute stroke B. Labovic a , S. Culafic b , T. Lepic a , R. Raicevic a . a Clinic of Nurology, Military Medical Academy, Serbia; b Radiology, Military Medical Academy, Institute of Radiology, Belgrade, Serbia Some of the methods of treatment for acute stroke after therapeutic window for intravenous thrombolysis (3–4.5 h) are neuro-interventional procedures: intra-arterial thrombolysis and endovascular potentiating of thrombolytic effect. Case report: Patient (64), admitted at 13 h, because of stroke, with severe right-sided limbs pyramidal deficit, motor dysphasia (NIHHS 14). First symptoms have appeared abruptly at 7 h. The patient underwent digital subtraction angiography (DSA) due to MSCT malfunction. The DSA finding 7 h after onset was occlusion of temporal branch of left MCA. Following DSA, aspiration thrombectomy was performed, using aspiration catheter size 4Fr, with thromb aspiration with negative pressure using syringe of 60 ml, and procedure is repeated until complete thromb extraction is achieved. Control DSA showed complete recanalization. Patient showed signs of fast recovery, initially in lower limb, immediately followed by recovery of upper limb, maintaining motor dysphasia (NIHHS 5). MR endocranium on the next day showed hyper density in zone of left MCA, 1 × 1.5 cm. Discussion: Based on experience in MMA in treatment with intra- arterial thrombolysis and aspiration techniques, of 5 treated patients, full recovery has been achieved in 4, while one resulted in death. It is a fact that patients with time expired on the therapeutic window for intravenous fibrinolysis, but immediately treated with intra-arterial fibrinolysis or mechanical thromb extraction as possible therapeutic option, have much better prognosis. Conclusion: Blood vessel recanalization in presented patient is achieved by effect of mechanical thromb extraction and it does not represent standard therapeutic procedure. Presented data indicate possibility of widening the therapeutic window. doi:10.1016/j.jns.2013.07.759 Abstract — WCN 2013 No: 1135 Topic: 3 — Stroke Low prevalence etiology in a patient with hemispheric stroke D. Popescu a , A. Mergeani a , B. Dorobat b , O. Bajenaru a , F. Antochi a . a Neurology, Bucharest University Emergency Hospital, Bucharest, Romania; b Interventional Radiology, Bucharest University Emergency Hospital, Bucharest, Romania Objectives: Atherosclerotic intracranial arterial stenosis is an important cause of stroke and it is increasingly being treated with percutaneous transluminal angioplasty and stenting to prevent recurrent stroke. In patients with intracranial arterial stenosis, aggressive medical manage- ment was superior to percutaneous transluminal angioplasty and stenting with the use of the Wingspan stent system, but there are no studies that compare transluminal balloon angioplasty to medical treatment. Methods: We present the case of a 76-year-old patient who presented to our clinic with recurrent syncope for neurologic assessment. The patient has a history of permanent atrial fibrillation, central retinal artery occlusion, and hypertension and has no history of prior neurological deficits. The ultrasonographic examination of cervical vessels was unremarkable for atherosclerotic disease but the CT examination of the head revealed a stroke in the cortical border zone between MCA and PCA. The cervico-cerebral artery digital substraction angiography revealed an intracranial stenosis of middle cerebral artery in M1 segment. Results: The patient underwent percutaneous transluminal balloon angioplasty of the stenosis of MCA in M1 segment without neurologic incidents or haemodynamic instability and was discharged with Clopidogrel and oral anticoagulant-cumarin derivate. Conclusion: We choose to perform percutaneous transluminal balloon angioplasty in a selected case of a patient with middle cerebral artery stenosis and multiple risk factors for stroke with good results and without complications. doi:10.1016/j.jns.2013.07.760 Abstract — WCN 2013 No: 1200 Topic: 3 — Stroke Clinico-immunological assessment of carotid atherosclerosis M. Danilova a , b , T. Baidina a . a Perm State Medical Academy, Russia; b Neurology, Perm State Medical Academy, Perm, Russia Background: Inflammation of the vessel wall is one of the pathogenic mechanisms of initiation and progression of atheroscle- rotic lesions, that are the most common cause of ischemic stroke. Objective: A comparison of the level of interleukin-6 (IL-6) and C- reactive protein (CRP) in blood serum in patients with different clinical manifestations of atherosclerosis of carotid arteries. Materials and methods: Atherosclerotic lesion of carotid arteries was detected by duplex scanning in 61patients. 23 of them had clinical manifestations of carotid atherosclerosis (stroke or transient ischemic attack) in history. The level of IL-6 and CRP in serum was determined in 61 patients with carotid artery disease by immuno- sorbent assay. Results: Patients with stroke in history had the increased concentration of IL-6 (8.0; 4.0–14.0 pg ml), the level of IL-6 in patients with asymptomatic carotid atherosclerosis was lower (4.6; 2.1–7.7 pg ml, р = 0.042). Concentration of CRP was higher (6.8; 4.9–14.2 mg l) in patients with clinical manifestations of atherosclerosis of precerebral arteries, than in patients with asymptomatic atherosclerosis (2.1; 1.3– 6.3 mg l, p = 0.002). The level of CRP in patients with atherothrombotic Abstracts / Journal of the Neurological Sciences 333 (2013) e152–e214 e187